Individual
RYAN VAN LIEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
31303 ELECTRIC AVE, NUEVO, CA 92567-9110
(951) 692-9544
Mailing address
31303 ELECTRIC AVE, NUEVO, CA 92567-9110
(951) 692-9544
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA61721
CA
Other
Enumeration date
09/29/2022
Last updated
09/29/2022
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