Pathma Neelika Bulathgama

Individual provider Active NPI Rehabilitation Practitioner · Artesia, CA

NPI 1376896050 · NPPES record last updated Oct 18, 2012

Key facts

NPI
1376896050
Entity type
Individual (NPI type 1)
Primary specialty
Rehabilitation Practitioner 225400000X
Practice address
18432 Gridley Rd
Artesia, CA 90701-5404
Phone
(562) 860-2479
Fax
(562) 860-7109
NPI assigned
Oct 18, 2012
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Clontarf Manor Inc. Past
since Jan 8, 2023
Accepting new patients
Clontarf Manor, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Practitioner 225400000X Yes

Addresses

Primary practice location

18432 Gridley Rd
Artesia, CA 90701-5404

Mailing address

14518 Cabell Ave
Bellflower, CA 90706-3205
Phone (562) 860-2479

Other providers in Artesia, CA

All providers in Artesia, CA · Rehabilitation Practitioner in California

Sources for this page

Verify at the official NPI Registry.