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General NPI Number Information
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NPI Number | 1598929960
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Entity Type | Individual
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Provider Name | NOEL D YSIP FNP
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Gender | Male
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Dates
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Enumeration Date | 07/15/2008
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Last Update Date | 02/26/2021
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Provider Practice Location Address
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Address Line | 2300 BOSWELL RD STE 190
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City | CHULA VISTA
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State | CA
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Zip | 91914-3535
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Country | US
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Telephone | 619-881-9021
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Fax | 619-216-5509
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Provider Business Mailing Address
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Address Line | 34800 BOB WILSON DR
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City | SAN DIEGO
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State | CA
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Zip | 92134-5000
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Country | US
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Telephone | 619-881-9021
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Fax | 619-216-5509
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 18249
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License Number State | CA
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