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NPI Code Detail

MEDICARE: IAN STUHMER

MEDICARE: IAN STUHMER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior Technician

General Provider Information

NPI Number : 1275031239
Entity Type Code : Individual
Provider Name (Legal Business Name) : IAN STUHMER
Provider Business Mailing Address
First Line : 5252 BALBOA ARMS DR UNIT 201
Second Line :
City : SAN DIEGO
State : CA
Zip : 92117-4935
Country : US
Telephone Number : 720-234-0703
Fax Number :
Provider Business Practice Location Address
First Line : 625 PENNSYLVANIA AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92103-4321
Country : US
Telephone Number : 858-603-4812
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/24/2018
Last Update Date : 03/17/2018

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Directions to “ IAN STUHMER ” Practice Location

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