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General NPI Number Information
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NPI Number | 1962273201
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Entity Type | Organization
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Legal Business Name | CLOUD NINE CLINICAL CONSULTANTS
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Dates
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Enumeration Date | 01/15/2024
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 4405 MANCHESTER AVE STE 207
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City | ENCINITAS
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State | CA
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Zip | 92024-7902
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Country | US
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Telephone | 760-730-2535
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Fax | 760-230-4199
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Provider Business Mailing Address
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Address Line | PO BOX 230547
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City | ENCINITAS
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State | CA
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Zip | 92023-0547
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Country | US
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Telephone | 619-218-2858
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Fax | 760-230-4199
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Authorized Official
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Title or Position | CEO
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Name | DR. PAUL SARGENT
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Credential | MD
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Telephone | 760-730-2535
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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