Healthcare Provider Details

I. General information

NPI: 1821904780
Provider Name (Legal Business Name): AHL VENTURES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2026
Last Update Date: 08/20/2026
Certification Date: 08/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4883 RONSON CT STE K
SAN DIEGO CA
92111-1812
US

IV. Provider business mailing address

4883 RONSON CT STE K
SAN DIEGO CA
92111-1812
US

V. Phone/Fax

Practice location:
  • Phone: 858-333-5075
  • Fax:
Mailing address:
  • Phone: 858-333-5075
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MADINA IZIMBETOVA
Title or Position: CEO
Credential:
Phone: 858-333-5075