Organization
HOME CARE MD MEDICAL GROUP
Active
Other names
Home Care MD Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
SHYLEE BAUTISTA TIAMSON FNP (NURSE PRACTITIONER)
(310) 292-0117
Entity
Organization
Contact information
Practice address
100 N BARRANCA ST # 900-J, WEST COVINA, CA 91791-1637
(626) 377-7608
(626) 206-0553
Mailing address
100 N BARRANCA ST # 900-J, WEST COVINA, CA 91791-1637
(626) 377-7608
(626) 206-0553
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
2083X0100X
Occupational Medicine Physician
—
—
363AM0700X
Medical Physician Assistant
—
—
363LF0000X
Family Nurse Practitioner
—
—
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/16/2020
Last updated
06/14/2021
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