Provider Demographics
NPI:1710658885
Name:DIRIYE, ABDIKADIR (RRT)
Entity Type:Individual
Prefix:MR
First Name:ABDIKADIR
Middle Name:
Last Name:DIRIYE
Suffix:
Gender:M
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2401 COMMERCIAL ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92113-1283
Mailing Address - Country:US
Mailing Address - Phone:619-739-0228
Mailing Address - Fax:
Practice Address - Street 1:2401 COMMERCIAL ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92113-1283
Practice Address - Country:US
Practice Address - Phone:619-739-0228
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-27
Last Update Date:2021-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA268962279C0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2279C0205XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, RegisteredCritical Care