Provider Demographics
NPI:1013014265
Name:RYLE, GARRETT P (MD)
Entity Type:Individual
Prefix:
First Name:GARRETT
Middle Name:P
Last Name:RYLE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:866-681-0736
Mailing Address - Fax:
Practice Address - Street 1:2725 CAPITOL AVE
Practice Address - Street 2:SUITE 302
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-6004
Practice Address - Country:US
Practice Address - Phone:916-262-9440
Practice Address - Fax:916-262-9445
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2015-05-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG32857207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G328570Medicaid
CA00G328570Medicaid
A45318Medicare UPIN