Provider Demographics
NPI:1447512983
Name:LA JOLLA SOL VENTURES INC
Entity type:Organization
Organization Name:LA JOLLA SOL VENTURES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RENEE
Authorized Official - Middle Name:R
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:858-999-4211
Mailing Address - Street 1:8950 VILLA LA JOLLA DR STE A125
Mailing Address - Street 2:
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92037-1706
Mailing Address - Country:US
Mailing Address - Phone:858-452-3502
Mailing Address - Fax:858-452-3503
Practice Address - Street 1:8950 VILLA LA JOLLA DR STE A125
Practice Address - Street 2:
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92037-1706
Practice Address - Country:US
Practice Address - Phone:858-452-3502
Practice Address - Fax:858-452-3503
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-11
Last Update Date:2018-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302422251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty