Individual
ASHLEY RYAN VIDAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
4441 TIAMO WAY, STOCKTON, CA 95212-2792
(650) 307-7903
Mailing address
4441 TIAMO WAY, STOCKTON, CA 95212-2792
(650) 307-7903
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/26/2022
Last updated
07/25/2022
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