Individual
EMILY BALTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1317 HUNTINGTON DR, SOUTH PASADENA, CA 91030-4511
(323) 341-5598
Mailing address
625 FAIR OAKS AVE, SOUTH PASADENA, CA 91030-2630
(323) 341-5580
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
174400000X
Specialist
Primary
—
—
Other
Enumeration date
10/27/2014
Last updated
10/27/2014
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