Individual
COLE MICHAEL ENSIGN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5400 KEARNY MESA RD, SAN DIEGO, CA 92111-1303
(619) 207-9808
Mailing address
5400 KEARNY MESA RD, SAN DIEGO, CA 92111-1303
(619) 207-9808
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
175T00000X
Peer Specialist
—
CA
Other
Enumeration date
06/24/2024
Last updated
07/15/2024
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