Individual
MIGUEL ANTONIO ULLOA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
245 W SIERRA MADRE BLVD, SIERRA MADRE, CA 91024-2355
(626) 314-7862
Mailing address
830 S CORAL TREE DR, WEST COVINA, CA 91791-3327
(626) 991-0122
Taxonomy
Speciality
Code
Description
License number
State
224Y00000X
Clinical Exercise Physiologist
Primary
—
—
Other
Enumeration date
06/20/2023
Last updated
06/20/2023
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