Individual
RYAN DOUGLAS BULLOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AUD
Contact information
Practice address
1360 W 6TH ST STE 243, SAN PEDRO, CA 90732-3589
(424) 570-0117
(424) 570-0499
Mailing address
600 MONTEREY BLVD APT 10, HERMOSA BEACH, CA 90254-4583
(479) 459-2261
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
—
—
Other
Enumeration date
10/10/2012
Last updated
09/26/2018
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