| NPI | 1619553591 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND BAUTISTA Medical Director 562-269-0300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Additional Taxonomies | 213ER0200X Podiatrist Radiology |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2021-03-22 |