Individual
ANDREW WILLIAM BOLAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RADT
Contact information
Practice address
132 W 10TH ST, SAN PEDRO, CA 90731-3702
(310) 514-4940
Mailing address
1003 S BEACON ST, SAN PEDRO, CA 90731-4324
(310) 514-4940
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
R1526620923
CA
Other
Enumeration date
04/16/2024
Last updated
04/16/2024
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