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Individual

DR. JOSE LUZA BAUTISTA III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2716 S ERIN CT, WALNUT, CA 91789-4638
(626) 665-6704
(626) 337-1231
Mailing address
1300 S SUNSET AVE, WEST COVINA, CA 91790-3342
(626) 960-6999
(626) 337-1231

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A35250
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A352500
CA
Enumeration date
09/05/2006
Last updated
07/08/2007
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