Bautista, Juan Mendoza

Bautista, Juan Mendoza is an sole proprietor health care provider with primary practice located at 6236 E Pima St Ste 100 , Tucson AZ 85712. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Bautista, Juan Mendoza can be contacted via phone (520) 327-6874.

Contact Information

Primary practice address
6236 E Pima St Ste 100 Tucson AZ 85712
Phone: (520) 327-6874
Fax: (520) 327-0028
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 49681 Arizona
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MT199475 Pennsylvania

Profile Details

NPI number 1619255007
LBN Legal business name Bautista, Juan Mendoza
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Aug 2nd, 2011
Last updated Oct 14th, 2019 - about 7 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 1619255007 NPPES
Arizona MEDICAID 985417

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