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1023762804
CALEB FANEN ICHULL-INGYA
SAN DIEGO, CA
NPI
1023762804
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Additional Taxonomies
175T00000X Peer Specialist
Enumeration Date
2022-02-09
Last Update Date
2023-03-27
Business Address
CALEB FANEN ICHULL-INGYA
8775 AERO DR STE 132
SAN DIEGO, CA 92123-1779
Phone number: 858-609-8742
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Mailing Address
CALEB FANEN ICHULL-INGYA
8775 AERO DR STE 132
SAN DIEGO, CA 92123-1779
Phone number: 562-414-9764
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