Provider Demographics
NPI:1316022866
Name:RYAN F. OSBORNE, M.D. INC.
Entity Type:Organization
Organization Name:RYAN F. OSBORNE, M.D. INC.
Other - Org Name:OSBORNE HEAD AND NECK INSTITUTE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:F
Authorized Official - Last Name:OSBORNE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-657-0123
Mailing Address - Street 1:PO BOX 451400
Mailing Address - Street 2:
Mailing Address - City:WESTCHESTER
Mailing Address - State:CA
Mailing Address - Zip Code:90045-8515
Mailing Address - Country:US
Mailing Address - Phone:310-657-0123
Mailing Address - Fax:310-657-0142
Practice Address - Street 1:8631 W 3RD ST
Practice Address - Street 2:SUITE 945E
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5901
Practice Address - Country:US
Practice Address - Phone:310-657-0123
Practice Address - Fax:310-657-0142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWA79242AMedicare PIN
CAW13103AMedicare PIN
CAWA64640CMedicare PIN
CAW17861Medicare PIN