Individual
FERNAND BAMBA TARUC
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3857 FOOTHILL BLVD STE 15C, GLENDALE, CA 91214-1658
(818) 319-0224
Mailing address
11014 ELDORA AVE, SUNLAND, CA 91040-2005
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
95012147
CA
363LG0600X
Gerontology Nurse Practitioner
Primary
95012147
CA
Other
Enumeration date
06/24/2007
Last updated
04/29/2025
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