Organization
TELEHEALTH CLINICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KAMERON IBRAHIM (PRESIDENT)
(619) 694-6389
Entity
Organization
Contact information
Practice address
2667 CAMINO DEL RIO SOUTH #207, SAN DIEGO, CA 92108-3765
(619) 694-6389
Mailing address
2667 CAMINO DEL RIO S STE 207, SAN DIEGO, CA 92108-3765
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
2016010806
CA
Other
Enumeration date
09/01/2016
Last updated
09/01/2016
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