Individual
CODY BULGARELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
11818 SOUTHFORK VIEW CT, WELDON, CA 93283-9509
(760) 223-2456
Mailing address
PO BOX 308, KERNVILLE, CA 93238-0308
(760) 223-2456
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
58569
CA
Other
Enumeration date
06/28/2020
Last updated
09/30/2020
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