Provider Demographics
NPI:1831493501
Name:BARNES, RYAN MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:RYAN
Middle Name:MICHAEL
Last Name:BARNES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7910 FROST ST
Mailing Address - Street 2:SUITE 450
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2771
Mailing Address - Country:US
Mailing Address - Phone:858-565-0104
Mailing Address - Fax:858-565-0194
Practice Address - Street 1:7910 FROST ST
Practice Address - Street 2:SUITE 450
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2771
Practice Address - Country:US
Practice Address - Phone:858-565-0104
Practice Address - Fax:858-565-0194
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-10
Last Update Date:2014-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH58.003311208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery