Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Ashley Ryan Vidad, DO

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1689324212

Ashley Ryan Vidad, DO is a Family Practice in Stockton, California. Qualified in 2022, 4 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth.

Years since qualifying
4
In the registry since
2022
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

4441 Tiamo Way
Stockton, CA 95212-2792
Phone: (650) 307-7903
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1102 Lyons St, Redwood City, CA 94061-2263 — (650) 307-7903

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1689324212
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 26, 2022
Last updated in NPPESJuly 25, 2022
Certification dateMarch 26, 2022
Mailing address4441 Tiamo Way, Stockton, CA 95212-2792

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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