Wesley Christopher Ryan, M.D

Primary specialty

Addiction Psychiatry PhysicianTaxonomy code 2084P0802X

License

A118134 Issued in CA

Practice address

4519 Admiralty Way Ste 202
Marina del Rey, CA 90292-5428

Phone

(424) 272-0774

Fax

(424) 291-8944

NPI assigned

Jul 10, 2010

Sex

Male

Sole proprietor

Yes

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)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: wryan753774@direct.ochin.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Wesley Ryan MD PC

  • Addiction Psychiatry Physician
  • Marina del Rey, CA
  • NPI 1588393847
  NPD Authorized official

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

{
    "created_epoch": "1278720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1275845901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4519 ADMIRALTY WAY STE 202",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925428",
            "telephone_number": "424-272-0774",
            "fax_number": "424-291-8944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4519 ADMIRALTY WAY STE 202",
            "city": "MARINA DEL REY",
            "state": "CA",
            "postal_code": "902925428",
            "telephone_number": "424-272-0774",
            "fax_number": "424-291-8944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RYAN",
        "first_name": "WESLEY",
        "middle_name": "CHRISTOPHER",
        "name_prefix": "Mr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-10",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CA",
            "license": "A118134",
            "primary": false
        },
        {
            "code": "2084P0802X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": "CA",
            "license": "A118134",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Addiction Psychiatry Physician in Marina del Rey, CA
• Providers in Marina del Rey, CA by specialty
• Addiction Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2021; 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.