Individual
DIEGO BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
324 S BEVERLY DRIVE #214, BEVERELY HILLS, CA 90212
(303) 922-4636
(303) 922-4640
Mailing address
4177 ISABELLA CIR, LAKE ELSINORE, CA 92530-2032
(714) 322-9932
(303) 922-4640
Taxonomy
Speciality
Code
Description
License number
State
246ZE0600X
Electroneurodiagnostic Specialist/Technologist
Primary
—
—
Other
Enumeration date
02/26/2019
Last updated
02/26/2019
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