Rancho Del Cielo Malibu
Clinic/Center in Malibu, CA. Organization (NPI-2).
NPI number1619307451
StatusActive
Last updated in NPPESNov 14, 2013
Details
- NPI
- 1619307451
- Entity type
- Organization (NPI-2)
- Legal business name
- Rancho Del Cielo Malibu
- Organization subpart
- No
- Enumeration date
- Nov 14, 2013
- Last updated
- Nov 14, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261Q00000X | Clinic/Center | – | – | Yes |
| 261QC1500X | Clinic/Center, Community Health | – | – | |
| 261QC1800X | Clinic/Center, Corporate Health | – | – | |
| 261QH0100X | Clinic/Center, Health Services | – | – |
Practice location
5591 De Butts TerMalibu, CA 90265-1709
Phone 310-589-9398
Mailing address
Po Box 6704Malibu, CA 90264-6704
Phone 310-589-9398
Authorized official
Sparky Greene
Ceo
3103445558
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