Individual
DR. RYAN ANTHONY FREDERIKSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13280 EVENING CREEK DR S, SAN DIEGO, CA 92128-4101
(805) 403-9924
Mailing address
13280 EVENING CREEK DR S, SAN DIEGO, CA 92128-4101
(805) 403-9924
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A108502
CA
2085R0202X
Diagnostic Radiology Physician
4301106997
MI
2085R0202X
Diagnostic Radiology Physician
Primary
A108502
CA
Other
Enumeration date
06/30/2008
Last updated
02/13/2025
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