Individual
AILENE BUNDALIAN RIVERA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
1711 W TEMPLE ST # 2056, LOS ANGELES, CA 90026-5421
(818) 634-6328
Mailing address
11024 BALBOA BLVD, 504, GRANADA HILLS, CA 91344-5007
(818) 634-6328
(818) 785-9332
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT28631
CA
Other
Enumeration date
07/06/2006
Last updated
01/12/2020
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