Provider Demographics
NPI:1578219762
Name:ROSENTHAL, RYLEY ELIZABETH (PA-C)
Entity type:Individual
Prefix:
First Name:RYLEY
Middle Name:ELIZABETH
Last Name:ROSENTHAL
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24411 HEALTH CENTER DRIVE STE. 680
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653
Mailing Address - Country:US
Mailing Address - Phone:949-268-4568
Mailing Address - Fax:949-455-2795
Practice Address - Street 1:24411 HEALTH CENTER DRIVE STE. 680
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653
Practice Address - Country:US
Practice Address - Phone:949-268-4568
Practice Address - Fax:949-455-2795
Is Sole Proprietor?:No
Enumeration Date:2022-02-25
Last Update Date:2025-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA60825363A00000X, 363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant