Individual
OSAMA BOULES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1860 1ST ST, LA VERNE, CA 91750-5307
(626) 586-9773
(626) 249-9191
Mailing address
1860 1ST ST, LA VERNE, CA 91750-5307
(626) 586-9773
(626) 249-9191
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
F6932398
CA
Other
Enumeration date
03/09/2022
Last updated
03/09/2022
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