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General NPI Number Information
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NPI Number | 1649936261
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Entity Type | Individual
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Provider Name | RYAN AIUMU
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Gender | Male
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Dates
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Enumeration Date | 11/09/2021
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Last Update Date | 11/16/2021
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Provider Practice Location Address
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Address Line | 701 E BALL RD STE 200
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City | ANAHEIM
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State | CA
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Zip | 92805-5924
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Country | US
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Telephone | 714-814-0272
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2498
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City | COSTA MESA
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State | CA
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Zip | 92628-2498
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 324500000X
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Taxonomy Name | Substance Abuse Rehabilitation Facility
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License Number |
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License Number State |
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