MEDICARE: TSEHAINESH AREFAINE KAHSAY

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
1	164X00000X	Licensed Vocational Nurse	VN229730	CA

General Provider Information

NPI Number	:	1255584629
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TSEHAINESH AREFAINE KAHSAY

Provider Business Mailing Address
First Line	:	4073 PULITZER PL APT 2
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-4218
Country	:	US
Telephone Number	:	858-450-3235
Fax Number	:

Provider Business Practice Location Address
First Line	:	4073 PULITZER PL APT 2
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92122-4218
Country	:	US
Telephone Number	:	858-405-6006
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/29/2008
Last Update Date	:	03/17/2011

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Directions to “ TSEHAINESH AREFAINE KAHSAY ” Practice Location

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