Individual
CHRISTOPHER M RYAN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BA
Contact information
Practice address
682 S CORONADO ST, LOS ANGELES, CA 90057-3406
(213) 388-5277
Mailing address
2699 N BEACHWOOD DR, LOS ANGELES, CA 90068-2339
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-MSVWLP
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MPSS-MSVWLP
CALMHSA CERTIFICATION NUMBER
CA
Enumeration date
11/15/2023
Last updated
11/15/2023
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