Provider Demographics
NPI:1558330472
Name:BABIAR, RYAN (DC)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:
Last Name:BABIAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 BRIDGEPORT
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3209
Mailing Address - Country:US
Mailing Address - Phone:847-209-3222
Mailing Address - Fax:
Practice Address - Street 1:5500 TRABUCO RD
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-5741
Practice Address - Country:US
Practice Address - Phone:949-478-5156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL038-008409111N00000X
CA31273111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL4532186OtherBCBSIL
U69124Medicare UPIN
ILK09514Medicare ID - Type Unspecified