Bautista, Jose Luza

Bautista, Jose Luza is an sole proprietor health care provider with primary practice located at 2716 S Erin Ct , Walnut CA 91789-4638. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Bautista, Jose Luza can be contacted via phone (626) 665-6704.

Contact Information

Primary practice address
2716 S Erin Ct Walnut CA 91789-4638
Fax: (626) 337-1231
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X A35250 California

Profile Details

NPI number 1063514487
LBN Legal business name Bautista, Jose Luza
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Sep 5th, 2006
Last updated Jul 8th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063514487 NPPES
California MEDICAID 00A352500

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