Organization
CEDRIC M. BAUTISTA M.D., A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CEDRIC M BAUTISTA M.D. (OWNER)
(760) 353-6200
Entity
Organization
Contact information
Practice address
1500 S IMPERIAL AVE, EL CENTRO, CA 92243-4241
(760) 353-6200
(760) 353-9817
Mailing address
PO BOX 2010, EL CENTRO, CA 92244-2010
(760) 353-6200
(760) 353-9817
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A37997
CA
Other
Enumeration date
02/28/2012
Last updated
02/28/2012
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