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1134417272
CARLOS BAUTISTA
BOISE, ID
NPI
1134417272
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: NY 243704-1)
Enumeration Date
2011-07-11
Last Update Date
2011-07-11
Business Address
CARLOS BAUTISTA MD
777 N RAYMOND ST
BOISE, ID 83704-9251
Phone number: 208-514-2500
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Mailing Address
CARLOS BAUTISTA MD
777 N RAYMOND ST
BOISE, ID 83704-9251
Phone number: 208-514-2500
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