# MANIJEH RYAN MD INC A PROFESSIONAL CORPORATION

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1699042507
- **Authorized official:** MANIJEH RYAN MD (PRESIDENT/MEDICAL DIRECTOR)
- **Authorized official phone:** (925) 765-7761

## Contact information

- **Practice address:** 3838 WATT AVE STE D404, SACRAMENTO, CA 95821-2665
- **Practice address phone:** (925) 765-7761
- **Practice address fax:** (510) 344-2556
- **Mailing address:** PO BOX 3765, WALNUT CREEK, CA 94598-0765
- **Mailing address phone:** (925) 349-5158

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2081N0008X | Neuromuscular Medicine (Physical Medicine & Rehabilitation) Physician | A117409 | CA | — |
| 2081P0301X | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | — | NULL | — |
| 2081P0301X | Brain Injury Medicine (Physical Medicine & Rehabilitation) Physician | — | — | — |
| 2081P2900X | Pain Medicine (Physical Medicine & Rehabilitation) Physician | A117409 | CA | Yes |
| 208VP0014X | Interventional Pain Medicine Physician | A117409 | CA | — |

## Other

- **Enumeration date:** 11/20/2011
- **Last updated:** 06/09/2022