Individual
DAN IVERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4283 EL CAJON BLVD STE 115, SAN DIEGO, CA 92105-1289
(619) 521-1743
Mailing address
4283 EL CAJON BLVD STE 115, SAN DIEGO, CA 92105-1289
(619) 521-1743
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
01/30/2015
Last updated
01/30/2015
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