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1346720679
IVAN BUSTAMANTE
DUARTE, CA
NPI
1346720679
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1041C0700X Social Worker, Clinical
(Licence: CA LCSW116016)
Enumeration Date
2018-08-16
Last Update Date
2024-05-15
Business Address
IVAN BUSTAMANTE
1801 HUNTINGTON DR
DUARTE, CA 91010-2635
Phone number: 626-993-3000
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Mailing Address
IVAN BUSTAMANTE
1801 HUNTINGTON DR
DUARTE, CA 91010-2635
Phone number: 626-993-3000
Copy
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