Provider Demographics
NPI:1568721058
Name:CHIO, RYAN ROGER VICTORIO (MD)
Entity Type:Individual
Prefix:
First Name:RYAN ROGER
Middle Name:VICTORIO
Last Name:CHIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:212 E 47TH ST APT 28C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-2127
Mailing Address - Country:US
Mailing Address - Phone:212-203-7034
Mailing Address - Fax:
Practice Address - Street 1:650 SOUTH ZEDIKER AVENUE
Practice Address - Street 2:
Practice Address - City:PARLIER
Practice Address - State:CA
Practice Address - Zip Code:93648-2666
Practice Address - Country:US
Practice Address - Phone:559-646-6618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-03
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124196208000000X, 261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No261Q00000XAmbulatory Health Care FacilitiesClinic/Center