KEN IVEN BANTOL

GRANADA HILLS, CA
NPI1841055811
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: CA  95027351)
Enumeration Date2024-02-19
Last Update Date2024-02-19
Business Address
KEN IVEN BANTOL PMHNP-BC
10400 GLORIA AVE
GRANADA HILLS, CA 91344-7123
Phone number: 818-867-0500
Mailing Address
KEN IVEN BANTOL PMHNP-BC
10400 GLORIA AVE
GRANADA HILLS, CA 91344-7123
Phone number:
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