Ryan Tait Vickers, PA-C, MMS

NPI #1700264777 in Simi Valley, California

Provider Information

NPI Number: 1700264777
Entity Type: Individual
Name: Ryan Tait Vickers, PA-C, MMS
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C, MMS
Enumeration Date: May 11, 2015
Last Updated: May 11, 2015

Practice Location

Address: 2975 SYCAMORE DR
City: Simi Valley
State: California
ZIP Code: 93065-1201
Phone: (805) 955-6000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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