Provider Demographics
NPI:1437493160
Name:PUHLEV, ISKREN G (FNP)
Entity Type:Individual
Prefix:MR
First Name:ISKREN
Middle Name:G
Last Name:PUHLEV
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5664 ARBOR GROVE CT
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121-4343
Mailing Address - Country:US
Mailing Address - Phone:858-222-3823
Mailing Address - Fax:
Practice Address - Street 1:3444 KEARNY VILLA RD STE 202
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-1960
Practice Address - Country:US
Practice Address - Phone:858-429-7646
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-19
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA22409363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily