Provider Information for 1366672636
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MARK A. RYLE
Sex: Male
NPI: 1366672636
Last Updated: 2024-04-26
Certification Date: 2024-04-26
Certification Date: 2024-04-26
Details
| Name | Value | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1366672636 | ||||||||||||
| Enumeration Date | 2009-07-21 | ||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||
| Sole Proprietor | NO | ||||||||||||
| Status | Active | ||||||||||||
| Mailing Address | 2275 ARLINGTON DR SAN LEANDRO, CA 94578-1132 United States Phone: | Fax: | ||||||||||||
| Primary Practice Address | 2275 ARLINGTON DR SAN LEANDRO, CA 94578-1132 United States Phone: 510-317-1444 | Fax: | ||||||||||||
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