Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. DOUG ALLEN GUSTAFSON, ARDMS,RVT,RDCS
Active Sole ProprietorMR. DOUG ALLEN GUSTAFSON, ARDMS,RVT,RDCS is a Physiological Laboratory healthcare provider located in AGUA DULCE, California. NPI 1760592984 is currently active in the NPPES registry. Verify at CMS.
Physiological Laboratory · AGUA DULCE, CA
Registration Details
- NPI Number
- 1760592984
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 30, 2006 (19.774885503996 yrs)
- Last Updated
- Jul 8, 2007
- Sole Proprietor
- Yes
Practice Information
- Address
-
34724 CAPROCK RDAGUA DULCE, CA, 913905422Browse CA providers · Browse ZIP 91390
- Phone
- 6612680791
- Fax
- 6612680792
- Primary Specialty
-
Physiological Laboratory
293D00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.