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Individual

MICHELLE BAUTISTA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
1000 W CARSON ST, TORRANCE, CA 90502-2004
(424) 330-6530
Mailing address
2324 TEVIS AVE, LONG BEACH, CA 90815-2236
(310) 702-5291

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95030704
CA

Other

Enumeration date
08/28/2024
Last updated
06/07/2025
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