Organization
DR MANUEL BAUSTISTA,INC,P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MANUEL BAUTISTA M.D. (PRESIDENT)
(253) 581-6303
Entity
Organization
Contact information
Practice address
9115 BRIDGEPORT WAY SW, SUITE #1, LAKEWOOD, WA 98499-2449
(253) 581-6303
(253) 581-3316
Mailing address
PO BOX 39398, LAKEWOOD, WA 98496-3398
(253) 581-6303
(253) 581-3316
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
—
—
Other
Enumeration date
06/03/2008
Last updated
06/05/2008
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