ETHAN STOCKDALE

CULVER CITY, CA
NPI1720810740
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Additional Taxonomies171M00000X Case Manager/Care Coordinator
Enumeration Date2024-08-19
Last Update Date2024-09-11
Business Address
ETHAN STOCKDALE
4760 SEPULVEDA BLVD
CULVER CITY, CA 90230-4820
Phone number: 310-390-6612
Mailing Address
ETHAN STOCKDALE
2051 GLENDON AVE
LOS ANGELES, CA 90025-6323
Phone number: 479-531-7713