# MICHELLE BAUTISTA

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

## Provider details

- **NPI number:** 1316112311
- **Authorized official:** MICHELLE BAUTISTA (CERTIFIED MEDICAL ASSISTANT)
- **Authorized official phone:** (619) 741-8988

## Contact information

- **Practice address:** 8707 TROY ST APT 105, SPRING VALLEY, CA 91977-2503
- **Practice address phone:** (619) 741-8988
- **Mailing address:** 8707 TROY ST APT 105, SPRING VALLEY, CA 91977-2503

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2865M2000X | Military General Acute Care Hospital | — | CA | Yes |

## Other

- **Enumeration date:** 04/29/2008
- **Last updated:** 04/30/2008