Provider Demographics
NPI:1598793663
Name:F. RYAN ANDERSON, MD
Entity Type:Organization
Organization Name:F. RYAN ANDERSON, MD
Other - Org Name:F. RYAN ANDERSON M.D. INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FREDERICK
Authorized Official - Middle Name:RYAN
Authorized Official - Last Name:ANDERSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:925-820-9898
Mailing Address - Street 1:909 SAN RAMON VALLEY BLVD
Mailing Address - Street 2:SUITE 214
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526
Mailing Address - Country:US
Mailing Address - Phone:925-820-9898
Mailing Address - Fax:925-820-6514
Practice Address - Street 1:909 SAN RAMON VALLEY BLVD
Practice Address - Street 2:SUITE 214
Practice Address - City:DANVILLE
Practice Address - State:CA
Practice Address - Zip Code:94526
Practice Address - Country:US
Practice Address - Phone:925-820-9898
Practice Address - Fax:925-820-6514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-29
Last Update Date:2009-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG21295207V00000X, 302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
No302R00000XManaged Care OrganizationsHealth Maintenance OrganizationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A41238Medicare UPIN
CA00G212950Medicare PIN