Individual
LIBIA ELENA BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2604 S VERMONT AVE STE F, LOS ANGELES, CA 90007-2298
(323) 731-3333
Mailing address
3857 DURFEE AVE, EL MONTE, CA 91732-2505
(626) 766-9705
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
RDA91293
CA
Other
Enumeration date
02/05/2020
Last updated
02/05/2020
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