Individual
GINA M BUCCOLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
IBCLC
Contact information
Practice address
1966 LUNDY AVE, PASADENA, CA 91104-1056
(626) 644-5483
Mailing address
1966 LUNDY AVE, PASADENA, CA 91104-1056
(626) 644-5483
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
Primary
—
—
Other
Enumeration date
06/29/2016
Last updated
06/29/2016
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