Individual
MR. BENJAMIN MARK V NABONG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
13400 SHERMAN WAY, NORTH HOLLYWOOD, CA 91605-4415
(818) 960-5314
Mailing address
17910 MALDEN ST, NORTHRIDGE, CA 91325-3818
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
12/17/2019
Last updated
12/17/2019
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