Individual
KYLE JONATHAN RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3030 CHILDRENS WAY, SAN DIEGO, CA 92123-4232
(858) 966-8974
Mailing address
3020 CHILDRENS WAY # MC5003, SAN DIEGO, CA 92123-4223
(858) 309-6300
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A170177
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1447645742
—
WI
Enumeration date
04/02/2015
Last updated
09/22/2020
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