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Individual

MISS MARIA CONSUELO BONTUYAN PADAL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
8121 VAN NUYS BLVD STE 510, PANORAMA CITY, CA 91402-5130
(818) 392-8115
Mailing address
8121 VAN NUYS BLVD STE 510, PANORAMA CITY, CA 91402-5130

Taxonomy

Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT29476
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
W20102A
GROUP MEDICARE PTAN
CA
Enumeration date
01/17/2008
Last updated
12/01/2021
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