Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Stockdale

Individual provider Case Manager/Care Coordinator · NPI 1720810740

Ethan Stockdale is a Case Manager/Care Coordinator in Culver City, California. Registered with an NPI since 2024.

In the registry since
2024
Specialties on file
2
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Practice location Address checks out

4760 Sepulveda Blvd
Culver City, CA 90230-4820
Phone: (310) 390-6612
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X
Case Manager/Care Coordinator Taxonomy 171M00000X

Record details

NPI number1720810740
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 19, 2024
Last updated in NPPESSeptember 11, 2024
Certification dateSeptember 11, 2024

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