Individual
DANIEL PABUSTAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
16365 SEQUOIA AVE, FONTANA, CA 92335-5679
(909) 224-4558
Mailing address
16365 SEQUOIA AVE, FONTANA, CA 92335-5679
(909) 224-4558
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
150.111772
IL
Other
Enumeration date
03/12/2024
Last updated
03/12/2024
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