Individual
ERIC JAMES BAUTISTA BOLISAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, APRN, FNP-BC
Contact information
Practice address
3622 CLARINGTON AVE APT 4, LOS ANGELES, CA 90034-5095
(310) 402-6367
Mailing address
3622 CLARINGTON AVE APT 4, LOS ANGELES, CA 90034-5095
(310) 402-6367
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
745584
CA
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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