Organization
RAYMOND BAUTISTA DPM, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAYMOND BAUTISTA DPM (MEDICAL DIRECTOR)
(562) 269-0300
Entity
Organization
Contact information
Practice address
701 E 28TH ST STE 111, LONG BEACH, CA 90806-2715
(562) 269-0300
Mailing address
701 E 28TH ST STE 111, LONG BEACH, CA 90806-2715
(562) 269-0300
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
—
—
213ER0200X
Radiology Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
Other
Enumeration date
03/22/2021
Last updated
03/22/2021
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