Individual
HAROLD BOB BALAZO MOLANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN, COTA
Contact information
Practice address
420 W WINDSOR RD APT 3, GLENDALE, CA 91204-1931
(310) 999-1098
Mailing address
420 W WINDSOR RD APT 3, GLENDALE, CA 91204-1931
(310) 999-1098
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3169
CA
Other
Enumeration date
05/28/2015
Last updated
05/28/2015
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