Individual
CYNTHIA M BAZAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
5575 LAKE PARK WAY STE 100-18, LA MESA, CA 91942-1664
(619) 259-4424
Mailing address
1508 PALM VIEW WAY, NATIONAL CITY, CA 91950-3660
(619) 259-4424
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
23628
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
23628
CAMTC
CA
Enumeration date
06/22/2023
Last updated
06/22/2023
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