Individual
BERNARDO BAUTISTA GONZALES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
11643 CENTRALIA ST, LAKEWOOD, CA 90715-1322
(661) 418-4611
Mailing address
11643 CENTRALIA ST, LAKEWOOD, CA 90715-1322
(661) 418-4611
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
—
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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