Individual
ETHAN ADAM AGUILAR BRAVO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1075 E BETTERAVIA RD STE 201, SANTA MARIA, CA 93454-7023
(805) 621-7714
Mailing address
40916 ROAD 56, REEDLEY, CA 93654-9133
(559) 740-2890
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
42870
CA
363A00000X
Physician Assistant
Primary
—
CA
Other
Enumeration date
01/04/2024
Last updated
02/06/2024
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