Individual
MRS. JOSEFINA ODULIO BAUTISTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MEDICAL ASSISTANT
Contact information
Practice address
4172 GAMMA ST, SAN DIEGO, CA 92113-4116
(619) 262-4506
Mailing address
4172 GAMMA ST, SAN DIEGO, CA 92113-4116
(619) 262-4506
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
—
—
Other
Enumeration date
07/31/2008
Last updated
07/31/2008
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