Individual
MR. YEVGENIY PUSTILNIKOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1335 N LA BREA AVE, APT#105, LOS ANGELES, CA 90028-7526
(323) 829-9261
Mailing address
1335 N LA BREA AVE APT 105, LOS ANGELES, CA 90028-7565
(323) 829-9261
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
18429
CA
364SG0600X
Gerontology Clinical Nurse Specialist
3055
CA
Other
Enumeration date
09/24/2008
Last updated
09/24/2008
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