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1265575781
GARY EDWARD BASTAJIAN
SAN BERNARDINO, CA
NPI
1265575781
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
106H00000X Marriage & Family Therapist
(Licence: CA MFC25259)
Enumeration Date
2007-02-14
Last Update Date
2007-07-08
Business Address
Mr. GARY EDWARD BASTAJIAN MFT
820 E GILBERT ST
SAN BERNARDINO, CA 92415-0002
Phone number: 909-387-7793
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Mailing Address
Mr. GARY EDWARD BASTAJIAN MFT
PO BOX 3533
CRESTLINE, CA 92325-3533
Phone number: 909-338-4113
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