Individual
WARREN DAICHI HICKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
34101 FAREHOLT AVE BUILDING 14, SAN DIEGO, CA 92134-0001
(619) 532-7968
Mailing address
1925 SKY HARBOR RD, SAN DIEGO, CA 92139-1025
(559) 707-0216
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
01/27/2021
Last updated
07/01/2021
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