Anthony Gerard Ryan, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

95024953 Issued in CA

Practice address

590 Traverse Dr
Costa Mesa, CA 92626-3117

Phone

(714) 966-8650

NPI assigned

Aug 21, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503273600000",
    "number": "1144746108",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 KALMUS DR STE 145",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926265988",
            "telephone_number": "714-966-8650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 TRAVERSE DR",
            "city": "COSTA MESA",
            "state": "CA",
            "postal_code": "926263117",
            "telephone_number": "714-966-8650"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "ANTHONY",
        "middle_name": "GERARD",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-21",
        "last_updated": "2017-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "CA",
            "license": "95024953",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "95024953",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charlotte Marie Russell, RNP
• Alia I Rust
• Lucia Rusu, MD
• Michael Allen Ruvalcaba
• Aleah Ryan, MSW
• Nicole Sabio
• Elizabeth Sablan, BCBA
• Sacred Seasons Collective
• Shafiga Saeed
• Taylor Marie Saewitz

• Registered Nurse in Costa Mesa, CA
• Providers in Costa Mesa, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.