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1790247047
MIGUEL BUSTAMANTE
COVINA, CA
NPI
1790247047
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA R1338340219)
Enumeration Date
2019-04-04
Last Update Date
2019-04-04
Business Address
MIGUEL BUSTAMANTE
540 S EREMLAND DR STE A
COVINA, CA 91723-3186
Phone number: 626-966-1577
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Mailing Address
MIGUEL BUSTAMANTE
540 S EREMLAND DR STE A
COVINA, CA 91723-3186
Phone number: 626-966-1577
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