Charles Sablan Bulda

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

49969 Issued in CA

Practice address

15115 S Vermont Ave
Gardena, CA 90247-4101

Phone

(310) 532-0700

NPI assigned

Dec 9, 2019

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1575849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575849600000",
    "number": "1487291480",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21501 S VERMONT AVE APT 208",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905021976",
            "telephone_number": "310-938-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15115 S VERMONT AVE",
            "city": "GARDENA",
            "state": "CA",
            "postal_code": "902474101",
            "telephone_number": "310-532-0700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULDA",
        "first_name": "CHARLES",
        "middle_name": "SABLAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-12-09",
        "last_updated": "2019-12-09",
        "certification_date": "2019-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "CA",
            "license": "49969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dylan Buenaventura
• Jasmine Moncerrat Bugarin Esparza, NONE
• Helen Bui
• Karena Bui, B.A.
• Kiyanazakiya Buie
• Arielle Bunag
• William Buresh
• Shamieka Burgess
• Lyubov Burgina, LMFT, PSYD
• Caroline Burgoa

• Physical Therapy Assistant in Gardena, CA
• Providers in Gardena, CA by specialty
• Physical Therapy Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.