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1790471134
ALEXANDER JORDAN TY STULL
SAN DIEGO, CA
NPI
1790471134
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Additional Taxonomies
175T00000X Peer Specialist
Enumeration Date
2023-04-17
Last Update Date
2023-04-27
Business Address
ALEXANDER JORDAN TY STULL
409 CAMINO DEL RIO S STE 201
SAN DIEGO, CA 92108-3505
Phone number: 619-381-7748
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Mailing Address
ALEXANDER JORDAN TY STULL
4930 NAPLES ST
SAN DIEGO, CA 92110-3820
Phone number: 619-276-1176
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