Ellis, Michael Mario

Ellis, Michael Mario is an individual health care provider with primary practice located at 1222 Monaco Ct #28, Stockton CA 95207-6742. He recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as his primary health care specialty. Ellis, Michael Mario can be contacted via phone (209) 644-6328.

Contact Information

Primary practice address
1222 Monaco Ct #28 Stockton CA 95207-6742
Phone: (209) 644-6328
Fax: (209) 644-6308
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X

Profile Details

NPI number 1609311315
LBN Legal business name Ellis, Michael Mario
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 4th, 2017
Last updated Jan 4th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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