Individual
BRANDO BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5109 HIGHLAND VIEW AVE, LOS ANGELES, CA 90041-1306
(323) 258-6856
Mailing address
5109 HIGHLAND VIEW AVE, LOS ANGELES, CA 90041-1306
(323) 258-6856
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
22778
CA
Other
Enumeration date
01/05/2012
Last updated
01/05/2012
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