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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1558155564

Dr. Ryan Cassidy Bohannan, DO is a Student in an Organized Health Care Education/Training Program in LA Jolla, California. Practices as a sole proprietor. Licensed in California.

Licensed in
CA
In the registry since
2025
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

9500 Gilman Dr
LA Jolla, CA 92093-5004
Phone: (909) 957-6124
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

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

Record details

NPI number1558155564
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorYes
NPI enumeratedApril 7, 2025
Last updated in NPPESApril 7, 2025
Certification dateMarch 30, 2025
Mailing addressPo Box 734, Chino, CA 91708-0734

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