Individual
ABRAHAM TONATIUH BALTAZAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4760 SEPULVEDA BLVD, CULVER CITY, CA 90230-4820
(310) 390-6612
Mailing address
1328 W MANCHESTER AVE, LOS ANGELES, CA 90044-2240
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
ASW123797
CA
Other
Enumeration date
07/08/2024
Last updated
08/01/2024
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