Provider Demographics
NPI:1972950830
Name:RYAN STYBEL OD INC.
Entity Type:Organization
Organization Name:RYAN STYBEL OD INC.
Other - Org Name:POSITIVE EYE ONS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LEAH
Authorized Official - Middle Name:
Authorized Official - Last Name:GATTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-651-5646
Mailing Address - Street 1:7629 MELROSE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90046-7419
Mailing Address - Country:US
Mailing Address - Phone:323-651-5646
Mailing Address - Fax:323-651-1426
Practice Address - Street 1:940 N. FAIRFAX AVE.
Practice Address - Street 2:
Practice Address - City:WEST HOLLYWOOD
Practice Address - State:CA
Practice Address - Zip Code:90046
Practice Address - Country:US
Practice Address - Phone:323-651-5646
Practice Address - Fax:323-651-1426
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2023-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAOPT13641TLG152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty