Individual
CHRISTIAN BANTASAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6080 CENTER DR., 6TH FLOOR SUITE # 639, LOS ANGELES, CA 90045
(888) 859-0145
Mailing address
PO BOX 1295, VENICE, CA 90294-1295
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
—
CA
225100000X
Physical Therapist
Primary
48983
CA
Other
Enumeration date
06/03/2022
Last updated
12/06/2022
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