Individual
MR. DOUG ALLEN GUSTAFSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARDMS,RVT,RDCS
Contact information
Practice address
34724 CAPROCK RD, AGUA DULCE, CA 91390-5422
(661) 268-0791
(661) 268-0792
Mailing address
34724 CAPROCK RD, AGUA DULCE, CA 91390-5422
(661) 268-0791
(661) 268-0792
Taxonomy
Speciality
Code
Description
License number
State
293D00000X
Physiological Laboratory
Primary
—
—
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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