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General NPI Number Information
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NPI Number | 1427460591
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Entity Type | Individual
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Provider Name | REGINALD ROMAIN BELLARD C.M.T.
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Gender | Male
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Dates
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Enumeration Date | 05/23/2014
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Last Update Date | 01/03/2020
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Provider Practice Location Address
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Address Line | 4429 W SLAUSON AVE STE 3/4
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City | LOS ANGELES
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State | CA
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Zip | 90043-2717
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Country | US
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Telephone | 323-833-8774
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Fax |
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Provider Business Mailing Address
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Address Line | 4429 W SLAUSON AVE STE 3/4
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City | LOS ANGELES
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State | CA
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Zip | 90043-2717
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Country | US
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Telephone | 323-833-8774
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | #11777
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License Number State | CA
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