Ryan M. Wilke, D.O., a Medical Corporation

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

RYAN M. WILKE, D.O., A MEDICAL CORPORATION

Practice address

11878 Avenue of Industry
San Diego, CA 92128-3423

Phone

(760) 317-5797

Fax

(858) 788-0071

NPI assigned

Apr 7, 2017

Last updated

Oct 7, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ryan Michael-David Wilke, D.O.NPI 1104186899

Title

Owner/President

Phone

(760) 317-5797

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Ryan M Wilke, D.O.

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1104186899
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1491523200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1759795200000",
    "number": "1386177251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "760-317-5797",
            "fax_number": "760-739-5792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11878 AVENUE OF INDUSTRY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283423",
            "telephone_number": "760-317-5797",
            "fax_number": "858-788-0071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RYAN M. WILKE, D.O., A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-07",
        "last_updated": "2025-10-07",
        "certification_date": "2025-10-07",
        "status": "A",
        "authorized_official_last_name": "WILKE",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "MICHAEL-DAVID",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "760-317-5797",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.