Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0100X | Gastroenterologist | A129683 | CA |
NPI | 1013151588 |
---|---|
Provider Name | Dr. Ryan Arthur Mcconnell |
First Address | Los Altos, CA 94022-1408 |
Second Address | Palo Alto, CA 94301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/04/2009 |
Last Update Date | 02/06/2020 |