Individual
CHRISTOPHER C BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5343 RIVERSIDE DR, CHINO, CA 91710-4252
(909) 591-4035
(909) 591-4112
Mailing address
5343 RIVERSIDE DR, CHINO, CA 91710-4252
(909) 591-4035
(909) 591-4112
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4176
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5238870001
MEDICARE NSC
CA
Enumeration date
09/25/2006
Last updated
09/11/2008
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