| NPI | 1619283942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER BAUTISTA Podiatrist 909-591-4035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332BC3200X Durable Medical Equipment & Medical Supplies, Customized Equipment (Licence: CA 5238870001) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2010-08-24 |