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General NPI Number Information
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NPI Number | 1508308941
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Entity Type | Organization
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Legal Business Name | ENSIGN
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Dates
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Enumeration Date | 11/16/2016
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Last Update Date | 11/16/2016
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Provider Practice Location Address
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Address Line | 680 CORTE REGALO
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City | CAMARILLO
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State | CA
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Zip | 93010-9107
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Country | US
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Telephone | 805-216-7633
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Fax |
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Provider Business Mailing Address
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Address Line | 680 CORTE REGALO
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City | CAMARILLO
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State | CA
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Zip | 93010-9107
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Country | US
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Telephone | 805-216-7633
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Fax |
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Authorized Official
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Title or Position | PHYSICAL THERAPIST ASSISTANT
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Name | MR. STEVEN ARTHUR MONZON I
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Credential | PTA
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Telephone | 805-216-7633
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | 3736
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License Number State | CA
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