Individual
CHARLES SABLAN BULDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
15115 S VERMONT AVE, GARDENA, CA 90247-4101
(310) 532-0700
Mailing address
21501 S VERMONT AVE APT 208, TORRANCE, CA 90502-1976
(310) 938-4292
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
49969
CA
Other
Enumeration date
12/09/2019
Last updated
12/09/2019
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