Healthcare Provider Details

I. General information

NPI: 1467259267
Provider Name (Legal Business Name): ANTHONY CIOE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2025
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36372 MONTEZUMA VALLEY RD
RANCHITA CA
92066-9758
US

IV. Provider business mailing address

1288 LOST ARROW PL
CHULA VISTA CA
91913-2800
US

V. Phone/Fax

Practice location:
  • Phone: 619-917-1223
  • Fax:
Mailing address:
  • Phone: 619-917-1223
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: