Individual
JOSE LUIS BAUTISTA GARCIA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1260 15TH ST STE 1502, SANTA MONICA, CA 90404-1135
(310) 656-1702
Mailing address
5767 W CENTURY BLVD STE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP95008698
CA
Other
Enumeration date
03/16/2018
Last updated
06/03/2024
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