Provider Demographics
NPI:1871927780
Name:HOWARD, RYAN WILLIAM
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:WILLIAM
Last Name:HOWARD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12707 CASWELL AVE
Mailing Address - Street 2:106
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-4781
Mailing Address - Country:US
Mailing Address - Phone:925-642-5193
Mailing Address - Fax:
Practice Address - Street 1:12707 CASWELL AVE
Practice Address - Street 2:106
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-4781
Practice Address - Country:US
Practice Address - Phone:925-642-5193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36152173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes173C00000XOther Service ProvidersReflexologist