Individual
DR. GRACE SEVILLA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
675 ARROYO PARKWAY, SUITE 330, PASADENA, CA 90640
(626) 395-5268
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 579-3203
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A045534
CA
207RI0200X
Infectious Disease Physician
Primary
A045534
CA
Other
Enumeration date
10/02/2006
Last updated
12/05/2025
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