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

Dr. Nicholas Ryan Whitley, MD

Individual provider Family Medicine Physician · NPI 1629394721

Dr. Nicholas Ryan Whitley, MD is a Family Practice in San Ysidro, California. Graduated from University of Southern California Keck School of Medicine in 2010, 16 years ago. Practices with Centro De Salud De La Comunidad De San Ysidro, Inc, a 291-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
16
Trained at
University of Southern California Keck School of Medicine
Licensed in
CA
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4004 Beyer Blvd
San Ysidro, CA 92173-2007
Phone: (619) 662-4100
Fax: (619) 428-7952
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A118250 (CA)

Record details

NPI number1629394721
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedApril 14, 2010
Last updated in NPPESJune 27, 2013
Mailing address4004 Beyer Blvd, San Ysidro, CA 92173-2007

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF SOUTHERN CALIFORNIA KECK SCHOOL OF MEDICINE
Graduated 2010 (16 years in practice)
Group practice Centro De Salud De La Comunidad De San Ysidro,Inc. — 291 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in San Ysidro