Provider Demographics
NPI:1194184952
Name:MORRIS, RYAN
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:MORRIS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3972 BARRANCA PKWY
Mailing Address - Street 2:SUITE J138
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-1204
Mailing Address - Country:US
Mailing Address - Phone:844-544-4980
Mailing Address - Fax:
Practice Address - Street 1:3972 BARRANCA PKWY
Practice Address - Street 2:SUITE J138
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-1204
Practice Address - Country:US
Practice Address - Phone:844-544-4980
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-22
Last Update Date:2016-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No172A00000XOther Service ProvidersDriver