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1720751068
EDWARD ANDREWMALCOM BUSTAMANTE
SAN BERNARDINO, CA
NPI
1720751068
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2021-07-30
Last Update Date
2024-01-04
Business Address
EDWARD ANDREWMALCOM BUSTAMANTE
1100 N D ST
SAN BERNARDINO, CA 92410-3524
Phone number: 909-884-0840
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Mailing Address
EDWARD ANDREWMALCOM BUSTAMANTE
1100 N D ST
SAN BERNARDINO, CA 92410-3524
Phone number: 909-884-0840
Copy
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