Individual
MR. ALLAN BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LVN
Contact information
Practice address
1772 W COLONIAL AVE, ANAHEIM, CA 92804-5508
(714) 609-2150
Mailing address
1772 W COLONIAL AVE, ANAHEIM, CA 92804-5508
(714) 609-2150
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN 238560
CA
Other
Enumeration date
06/09/2015
Last updated
06/09/2015
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