Organization
BRIGHT STAR
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HARRY AYALA (EXECUTIVE DIRECTOR)
(714) 730-7700
Entity
Organization
Contact information
Practice address
17291 IRVINE BLVD, SUITE 325, TUSTIN, CA 92780-2941
(714) 730-7700
(714) 730-7766
Mailing address
17291 IRVINE BLVD, SUITE 325, TUSTIN, CA 92780-2941
(714) 730-7700
(714) 730-7766
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
SP 10738
CA
Other
Enumeration date
07/20/2011
Last updated
07/02/2013
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