Individual
GRACE HAU-YAN BULLOCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
13652 CANTARA ST, PANORAMA CITY, CA 91402-5423
(818) 521-8824
Mailing address
13652 CANTARA ST, PANORAMA CITY, CA 91402-5423
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
A154888
CA
Other
Enumeration date
03/28/2016
Last updated
08/09/2024
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