Individual
RUDOLPH RAYMOND BREILEIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
70 N HUDSON AVE, PASADENA, CA 91101-1808
(626) 795-8471
Mailing address
34 S MENTOR AVE, #112, PASADENA, CA 91106-2927
(626) 731-0547
Taxonomy
Speciality
Code
Description
License number
State
167G00000X
Licensed Psychiatric Technician
Primary
PT21287
CA
Other
Enumeration date
02/13/2007
Last updated
07/08/2007
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