Individual
ITAGIA POUMELE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7986 DAGGET ST, SAN DIEGO, CA 92111-2321
(858) 300-0460
Mailing address
7986 DAGGET ST, SAN DIEGO, CA 92111-2321
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
06/24/2021
Last updated
09/28/2023
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