Provider Demographics
NPI:1699192716
Name:COBB, RYAN HATCHER (MS AT,C)
Entity Type:Individual
Prefix:MR
First Name:RYAN
Middle Name:HATCHER
Last Name:COBB
Suffix:
Gender:M
Credentials:MS AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:510 CONTADA CIR
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94526-3530
Mailing Address - Country:US
Mailing Address - Phone:510-643-4564
Mailing Address - Fax:
Practice Address - Street 1:170 SIMPSON CENTER UC BERKELEY
Practice Address - Street 2:CAL SPORTS MEDICINE
Practice Address - City:BERKELEY
Practice Address - State:CA
Practice Address - Zip Code:94720-0001
Practice Address - Country:US
Practice Address - Phone:510-642-4878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer