Individual
ALVIN ANSELMO CRUZ BOMBASE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPT, CEAS
Contact information
Practice address
24920 WALNUT ST, LOMITA, CA 90717-1925
(310) 293-7416
Mailing address
16630 S BROADWAY, GARDENA, CA 90248-2716
(310) 768-8155
(310) 768-8313
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT28286
CA
2251E1200X
Ergonomics Physical Therapist
28286
CA
2251X0800X
Orthopedic Physical Therapist
28286
CA
Other
Enumeration date
03/22/2007
Last updated
12/13/2021
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