# RAYMOND BAUTISTA DPM, INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1285219634
- **Authorized official:** DR. RAYMOND BAUTISTA DPM (MEDICAL DIRECTOR)
- **Authorized official phone:** (818) 430-6312

## Contact information

- **Practice address:** 701 E 28TH ST STE 111, LONG BEACH, CA 90806-2715
- **Practice address phone:** (562) 426-2551
- **Mailing address:** 1445 VALLEY VIEW RD APT 1, GLENDALE, CA 91202-1721

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 03/16/2021
- **Last updated:** 03/16/2021