Provider Demographics
NPI:1659545796
Name:UTARNACHITT, RYAN BUCANI (MD, MA, MPH)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:BUCANI
Last Name:UTARNACHITT
Suffix:
Gender:M
Credentials:MD, MA, MPH
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Mailing Address - Street 1:1419 N ACACIA AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:REEDLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93654-2197
Mailing Address - Country:US
Mailing Address - Phone:559-391-3160
Mailing Address - Fax:
Practice Address - Street 1:3800 S WHITNEY AVE STE 200
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-6739
Practice Address - Country:US
Practice Address - Phone:816-478-4887
Practice Address - Fax:816-478-7140
Is Sole Proprietor?:No
Enumeration Date:2008-04-19
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2017044163207RG0100X
CAA100613208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAFU0462870OtherDEA
CAA100613OtherMEDICAL LICENSE CA