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Individual

IAN SCHULTHEISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
14677 MERRIL AVENUE, FONTANA, CA 92335
(951) 643-2335
Mailing address
20205 LAYTON ST, CORONA, CA 92881-4869
(951) 833-1297

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
11/14/2018
Last updated
11/14/2018
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