Individual
DAVID HAIM BOLOUR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
604 ROSE AVE, VENICE, CA 90291-2767
(323) 383-5322
Mailing address
604 ROSE AVE, VENICE, CA 90291-2767
(323) 383-5322
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
A136515
CA
Other
Enumeration date
05/23/2012
Last updated
05/11/2022
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