Individual
BRYAN LAVERDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2117 ELDEN AVE APT 14, COSTA MESA, CA 92627-1783
(949) 873-4901
Mailing address
2117 ELDEN AVE APT 14, COSTA MESA, CA 92627-1783
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
91934
CA
Other
Enumeration date
11/30/2023
Last updated
04/23/2025
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