Individual
LAURA ELLEN BULATAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1959 KINGSDALE AVE, REDONDO BEACH, CA 90278-3417
(310) 214-1000
Mailing address
1959 KINGSDALE AVE, REDONDO BEACH, CA 90278-3417
(310) 214-1000
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95029055
CA
Other
Enumeration date
02/27/2024
Last updated
02/27/2024
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