Individual
CAROLYN BULLARD YARDIMIAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
886 MAGNOLIA AVE, STE. 100, CORONA, CA 92879-3105
(951) 340-3402
(951) 340-3416
Mailing address
24630 WASHINGTON AVE, STE. 200, MURRIETA, CA 92562-6177
(951) 696-9353
(951) 973-7216
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT37123
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT371230
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
08/30/2010
Last updated
12/10/2013
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