Individual
AMANDA BASTIEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8635 W 3RD ST STE 590W, LOS ANGELES, CA 90048-6163
(310) 423-1220
Mailing address
8635 W THIRD ST #590W, LOS ANGELES, CA 90048
(310) 423-1220
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/15/2021
Last updated
04/15/2021
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