MEDICARE: RYAN CHRISTOPHER MONAGLE D.P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	36399	CA

General Provider Information

NPI Number	:	1730410531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RYAN CHRISTOPHER MONAGLE D.P.T.

Provider Business Mailing Address
First Line	:	2330 VIA FRANCISCA
Second Line	:	APT 16C
City	:	CARLSBAD
State	:	CA
Zip	:	92008-6821
Country	:	US
Telephone Number	:	503-930-1507
Fax Number	:	858-485-7052

Provider Business Practice Location Address
First Line	:	11501 RANCHO BERNARDO RD
Second Line	:	SUITE 100
City	:	SAN DIEGO
State	:	CA
Zip	:	92127-1406
Country	:	US
Telephone Number	:	858-485-6706
Fax Number	:	858-485-7052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/19/2010
Last Update Date	:	01/19/2010

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