Individual
NIGIST TILAHUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
9943 JEREMY ST, SANTEE, CA 92071-1948
(619) 227-0383
Mailing address
10210 SAN DIEGO MISSION RD APT 64, SAN DIEGO, CA 92108-2179
(619) 376-5504
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F2132543
DRIVER LICENSE
CA
Enumeration date
03/23/2020
Last updated
03/23/2020
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