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Individual

BOBBY SUMINISTRADO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
4211 TIERRA REJADA RD, MOORPARK, CA 93021-3772
(805) 529-8076
(805) 523-8796
Mailing address
25115 AVENUE STANFORD STE B135, VALENCIA, CA 91355-1290
(661) 250-9940
(661) 250-9959

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
53568
CA

Other

Enumeration date
09/16/2024
Last updated
09/16/2024
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