Individual
MR. RYAN MICHAEL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
36485 INLAND VALLEY DR, WILDOMAR, CA 92595-9681
(951) 566-5610
Mailing address
36485 INLAND VALLEY DR, WILDOMAR, CA 92595-9681
(951) 566-5610
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA21959
CA
Other
Enumeration date
12/09/2011
Last updated
11/29/2021
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