Individual
RYAN K AH SAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
29472 AVENIDA DE LAS BANDERA, RANCHO SANTA MARGARITA, CA 92688-2651
(949) 459-9968
(949) 766-2565
Mailing address
17360 BROOKHURST ST, ATTN: MCMF - CREDENTIALING DEPARTMENT, FOUNTAIN VALLEY, CA 92708-3720
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA15744
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA15744
STATE LICENSE
CA
Enumeration date
04/17/2008
Last updated
03/09/2016
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