Bryan Jimenez
Student in an Organized Health Care Education/Training Program in San Diego, CA. Individual provider (NPI-1).
NPI number1669946091
StatusActive
Last updated in NPPESOct 21, 2025
Details
- NPI
- 1669946091
- Entity type
- Individual (NPI-1)
- Name
- Bryan Jimenez
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jan 18, 2019
- Certification date
- Oct 21, 2025
- Last updated
- Oct 21, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
480 Alta RdSan Diego, CA 92179-0001
Phone 619-661-6500
Mailing address
1915 Porter StSan Bernardino, CA 92407-6539
Phone 909-246-9569
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