Individual
MARVIN BALBUENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
3241 E CALLE BAJA DR, WEST COVINA, CA 91792-2902
(626) 736-7471
Mailing address
3241 E CALLE BAJA DR, WEST COVINA, CA 91792-2902
(626) 736-7471
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA4451
CA
Other
Enumeration date
12/01/2019
Last updated
12/01/2019
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