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1548965957
LUIS OSCAR BAUTISTA
FONTANA, CA
NPI
1548965957
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2023-04-04
Last Update Date
2023-05-25
Business Address
LUIS OSCAR BAUTISTA MD
15309 ATHOL ST
FONTANA, CA 92335-4351
Phone number: 909-910-8855
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Mailing Address
LUIS OSCAR BAUTISTA MD
14350 MERIDIAN PKWY STE 2
RIVERSIDE, CA 92518-3035
Phone number: 909-910-8855
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