Individual
ANGELE RYAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 SAN PABLO ST, USC UNIVERSITY HOSPITAL, LOS ANGELES, CA 90033-5313
(323) 442-7400
(323) 442-7411
Mailing address
1520 SAN PABLO ST, SUITE 3451, LOS ANGELES, CA 90033-5310
(323) 442-7400
(323) 442-7411
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
G28482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G284820
BLUE SHIELD
CA
05
—
00G284820
—
CA
01
—
00G284820328
CALOPTIMA
CA
01
—
050089594
RAILROAD MEDICARE
CA
Enumeration date
05/30/2006
Last updated
09/01/2011
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