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1518525575
JOSE ANTONIO BALTAZAR
HUNTINGTON PARK, CA
NPI
1518525575
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225400000X Rehabilitation Practitioner
Enumeration Date
2019-06-04
Last Update Date
2019-06-04
Business Address
JOSE ANTONIO BALTAZAR
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255-3699
Phone number: 323-346-0960
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Mailing Address
JOSE ANTONIO BALTAZAR
2677 ZOE AVE STE 304
HUNTINGTON PARK, CA 90255-3699
Phone number: 323-346-0960
Copy
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