| I Am Recovery Inc | |
|
845 15th St Ste 103 San Diego CA 92101-8098 | |
| (425) 344-3949 | |
| Not Available |
| Full Name | I Am Recovery Inc |
|---|---|
| Speciality | Preventive Medicine |
| Location | 845 15th St Ste 103, San Diego, California |
| Authorized Official Name and Position | Daniel Solomon Ageze (OWNER) |
| Authorized Official Contact | 4253443949 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| I Am Recovery Inc 845 15th St Ste 103 San Diego CA 92101-8098 Ph: (425) 344-3949 | I Am Recovery Inc 845 15th St Ste 103 San Diego CA 92101-8098 Ph: (425) 344-3949 |
| NPI Number | 1225806359 |
|---|---|
| Provider Enumeration Date | 12/18/2023 |
| Last Update Date | 10/29/2024 |
| Certification Date | 10/29/2024 |
| Medicare PECOS PAC ID | 4082147178 |
|---|---|
| Medicare Enrollment ID | O20241028003513 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225806359 | NPI | - | NPPES |
| Provider Name | Daniel S Ageze |
|---|---|
| Provider Type | Practitioner - Addiction Medicine |
| Provider Identifiers | NPI Number: 1922531524 PECOS PAC ID: 3577983725 Enrollment ID: I20240411001831 |
| Provider Name | Nebiyu Shukur |
|---|---|
| Provider Type | Practitioner - Emergency Medicine |
| Provider Identifiers | NPI Number: 1912430547 PECOS PAC ID: 3779987862 Enrollment ID: I20241127001454 |
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