Individual
GABRIELLE MARIE BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
19231 SOLEDAD CANYON RD, CANYON COUNTRY, CA 91351-3367
(661) 430-9040
Mailing address
PO BOX 134, CASTAIC, CA 91310-0134
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA63361
CA
Other
Enumeration date
09/21/2023
Last updated
02/20/2024
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