Provider Demographics
NPI:1689817819
Name:LUGINBUHL, RYAN DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:DAVID
Last Name:LUGINBUHL
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 1:840 LARRABEE ST
Mailing Address - Street 2:APARTMENT 4-303
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90069-4540
Mailing Address - Country:US
Mailing Address - Phone:310-913-8502
Mailing Address - Fax:
Practice Address - Street 1:840 LARRABEE ST
Practice Address - Street 2:APARTMENT 4-303
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90069-4540
Practice Address - Country:US
Practice Address - Phone:310-913-8502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA117281208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice