Individual
ANDRE CONWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
IDC STUDENT
Contact information
Practice address
34101 FARENHOLT AVE, SAN DIEGO, CA 92134-7000
(619) 532-9712
Mailing address
BUILDING 14, 34101 FARENHOLT AVE, SAN DIEGO, CA 92134
(619) 532-9712
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
01/26/2021
Last updated
01/26/2021
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