Individual
GUSTAVO CORONA JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
245 W SIERRA MADRE BLVD # CA91024, SIERRA MADRE, CA 91024-2355
(626) 355-5700
Mailing address
2130 SAWTELLE BLVD STE 300, LOS ANGELES, CA 90025-6266
(626) 589-0787
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
18371
CA
Other
Enumeration date
02/09/2018
Last updated
06/12/2020
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