Provider Demographics
NPI:1558505719
Name:TAYLOR, RYAN RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:RICHARD
Last Name:TAYLOR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:611 S CLOVERDALE AVE
Mailing Address - Street 2:APT. 208
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90036-4164
Mailing Address - Country:US
Mailing Address - Phone:847-708-8090
Mailing Address - Fax:
Practice Address - Street 1:MATTEL CHILDRENS HOSPITAL AT UCLA
Practice Address - Street 2:10833 LE CONTE AVE., 12-494, MDCC
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-416-9799
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-30
Last Update Date:2009-04-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA1003672080P0203X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0203XAllopathic & Osteopathic PhysiciansPediatricsPediatric Critical Care Medicine