Individual
CINDY LEE BASTIANON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
59462 RD. 225, SPC 1, NORTH FORK, CA 93643
(559) 741-5089
Mailing address
59462 RD. 225, SPC 1, NORTH FORK, CA 93643
(559) 741-5089
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
PT24195
CA
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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