Provider Demographics
NPI:1114344173
Name:RYAN, LAURA FRISCHER (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:FRISCHER
Last Name:RYAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:MICHELLE
Other - Last Name:FRISCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:11480 BROOKSHIRE AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-5021
Mailing Address - Country:US
Mailing Address - Phone:562-806-0874
Mailing Address - Fax:
Practice Address - Street 1:11480 BROOKSHIRE AVE STE 200
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-5021
Practice Address - Country:US
Practice Address - Phone:562-806-0874
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-27
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA138727207R00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program