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Individual

KEITH A CANDELARIA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, ATC

Contact information

Practice address
13847 EARLHAM DR, WHITTIER, CA 90602-6669
(562) 907-4965
(562) 945-8024
Mailing address
9253 MYRON ST, PICO RIVERA, CA 90660-5246
(562) 544-1202

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000007169
CA

Other

Enumeration date
11/01/2016
Last updated
11/01/2016
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