Individual
BISHESH GAUTAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
2580 GANAHL ST, LOS ANGELES, CA 90033-2015
(626) 644-6336
Mailing address
2580 GANAHL ST, LOS ANGELES, CA 90033-2015
(626) 644-6336
Taxonomy
Speciality
Code
Description
License number
State
225XP0200X
Pediatric Occupational Therapist
Primary
19641
CA
Other
Enumeration date
12/03/2019
Last updated
09/25/2025
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