Provider Demographics
NPI:1700293214
Name:ALDRIDGE, NICHOLAS RYAN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:RYAN
Last Name:ALDRIDGE
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 W ARBOR DR # MC8676
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-1911
Mailing Address - Country:US
Mailing Address - Phone:619-543-4627
Mailing Address - Fax:619-543-3115
Practice Address - Street 1:200 W ARBOR DR # MC8676
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-1911
Practice Address - Country:US
Practice Address - Phone:619-543-4627
Practice Address - Fax:619-543-3115
Is Sole Proprietor?:No
Enumeration Date:2014-07-16
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA138680207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine