Individual
MARLON BAUTISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
3801 MIRANDA AVE, PALO ALTO, CA 94304-1207
(650) 493-5000
(650) 858-8920
Mailing address
5287 CARLINO CT, ANTIOCH, CA 94531-5019
(510) 326-7033
Taxonomy
Speciality
Code
Description
License number
State
163WR0400X
Rehabilitation Registered Nurse
Primary
651510
CA
Other
Enumeration date
11/22/2024
Last updated
11/22/2024
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