Individual
MR. BRUCE GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC.
Contact information
Practice address
3218 18TH ST, SANTA MONICA, CA 90405-5928
(310) 399-1040
(866) 508-1580
Mailing address
3218 18TH ST, SANTA MONICA, CA 90405-5928
(310) 399-1040
(866) 508-1580
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
17333
CA
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
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