Organization
RAYMOND BAUTISTA DPM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND BAUTISTA DPM (MEDICAL DIRECTOR)
(818) 430-6312
Entity
Organization
Contact information
Practice address
701 E 28TH ST STE 111, LONG BEACH, CA 90806-2715
(562) 426-2551
Mailing address
1445 VALLEY VIEW RD APT 1, GLENDALE, CA 91202-1721
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
03/16/2021
Last updated
03/16/2021
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