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Organization
MARIA C BAUTISTA MD INC
Active
Organization
MARIA C BAUTISTA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARIA CORAZON BAUTISTA M.D. (PRESIDENT)
(858) 722-4779
Entity
Organization
Contact information
Practice address
11878 AVENUE OF INDUSTRY, SAN DIEGO, CA 92128-3423
(858) 722-4779
Mailing address
PO BOX 1770, LA MESA, CA 91944-1770
(858) 722-4779
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A41768
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A417680
—
CA
Enumeration date
09/22/2006
Last updated
02/24/2020
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