1366871048 NPI number — RYLIST, INC

Table of content: DAVID YEE M.D. (NPI 1205806809)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366871048 NPI number — RYLIST, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RYLIST, INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
LA VENTANA TREATMENT PROGRAMS
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1366871048
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/09/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
275 E HILLCREST DR
Provider Second Line Business Mailing Address:
120
Provider Business Mailing Address City Name:
THOUSAND OAKS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
91360-5827
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-777-3783
Provider Business Mailing Address Fax Number:
805-777-3784

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 E ARRELLAGA ST
Provider Second Line Business Practice Location Address:
101
Provider Business Practice Location Address City Name:
SANTA BARBARA
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
93103-2274
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-777-3873
Provider Business Practice Location Address Fax Number:
805-777-3874
Provider Enumeration Date:
11/04/2013

Additional Information

Authorized Official

Authorized Official Last Name:
ZAMIRRIPA
Authorized Official First Name:
STEVE
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
818-584-5615

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  41701 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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