Ryan Tait Vickers, PA-C, MMS

Physician Assistant · Simi Valley, CA

Individual Active NPI

NPI number 1700264777

Practice location

2975 Sycamore Dr
Simi Valley, CA 93065-1201
Phone
(805) 955-6000

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NPI record

NPI
1700264777
Entity type
Individual (Type 1)
Enumeration date
May 11, 2015
Last updated
May 11, 2015
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Physician Assistant Primary 363A00000X 52475 CA

About Ryan Vickers

Ryan Tait Vickers, PA-C, MMS is a healthcare provider registered in the NPI registry with the primary taxonomy Physician Assistant (code 363A00000X). The practice location is 2975 Sycamore Dr, Simi Valley, CA 93065-1201. The NPI number 1700264777 was assigned on May 11, 2015 and the record was last updated on May 11, 2015.

Ryan Vickers lists a license in the registry: #52475 (CA) for Physician Assistant. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Ryan Tait Vickers, PA-C, MMS?

The NPI number is 1700264777.

What is the phone number of Ryan Vickers?

The phone number listed for the practice location is (805) 955-6000.

Where is Ryan Vickers located?

2975 Sycamore Dr, Simi Valley, CA 93065-1201.

What is the taxonomy code for Ryan Vickers?

The primary taxonomy code is 363A00000X – Physician Assistant.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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