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1811496672
JAMES BENJAMIN BACON
TARZANA, CA
NPI
1811496672
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)
Enumeration Date
2018-02-07
Last Update Date
2018-02-07
Business Address
JAMES BENJAMIN BACON
18646 OXNARD ST
TARZANA, CA 91356-1411
Phone number: 818-996-1051
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Mailing Address
JAMES BENJAMIN BACON
10982 TOPEKA DR
NORTHRIDGE, CA 91326-2322
Phone number: 818-261-2456
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