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NPI Code Detail

MEDICARE: IVONNE ARIAS

MEDICARE: IVONNE ARIAS
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
1390200000XStudent in an Organized Health Care Education/Training ProgramCA

General Provider Information

NPI Number : 1689113342
Entity Type Code : Individual
Provider Name (Legal Business Name) : IVONNE ARIAS
Provider Business Mailing Address
First Line : 9055 BALBOA AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1509
Country : US
Telephone Number : 619-452-9985
Fax Number :
Provider Business Practice Location Address
First Line : 9055 BALBOA AVE
Second Line :
City : SAN DIEGO
State : CA
Zip : 92123-1509
Country : US
Telephone Number : 619-452-9985
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2017
Last Update Date : 08/23/2024

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Directions to “ IVONNE ARIAS ” Practice Location

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