Provider Demographics
NPI:1730410531
Name:MONAGLE, RYAN CHRISTOPHER (DPT)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:CHRISTOPHER
Last Name:MONAGLE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 VIA FRANCISCA
Mailing Address - Street 2:APT 16C
Mailing Address - City:CARLSBAD
Mailing Address - State:CA
Mailing Address - Zip Code:92008-6821
Mailing Address - Country:US
Mailing Address - Phone:503-930-1507
Mailing Address - Fax:858-485-7052
Practice Address - Street 1:11501 RANCHO BERNARDO RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92127-1406
Practice Address - Country:US
Practice Address - Phone:858-485-6706
Practice Address - Fax:858-485-7052
Is Sole Proprietor?:No
Enumeration Date:2010-01-19
Last Update Date:2010-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA36399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist