Individual
IVAN ADALBERTO FELIX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
995 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4500
(619) 772-2579
Mailing address
1031 25TH ST, SAN DIEGO, CA 92102-2194
(619) 232-6454
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
11/17/2023
Last updated
04/03/2025
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