Raymundo S Bautista, MD, Prof Corp

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

A52874 Issued in CA

Legal business name

RAYMUNDO S BAUTISTA, MD, PROF CORP

Practice address

118 W Foothill Blvd
Glendora, CA 91741-3364

Phone

(626) 914-3871

Fax

(626) 963-2816

NPI assigned

Feb 23, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Raymundo Sevilla Bautista, M.D.NPI 1912099441

Title

President

Phone

(626) 914-3871

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Tax ID family

Raymundo S Bautista MD Apc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Raymundo S. Bautista M.D. Apc

  • Nephrology Physician
  • West Covina, CA
  • NPI 1710115456
  NPD tax ID

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Raymundo Sevilla Bautista, MD

  • Internal Medicine Physician
  • Glendora, CA
  • NPI 1912099441
  Medicare reassignment NPD Authorized official
• Romelda Capitly Estrada, NP

  • Family Nurse Practitioner
  • Glendora, CA
  • NPI 1841061470
  Medicare reassignment NPD
• Priscilla Therese Salvador

  • Nurse Practitioner
  • Glendora, CA
  • NPI 1982342812
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1172188800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346371200000",
    "number": "1023143427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 W FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413364",
            "telephone_number": "626-914-3871",
            "fax_number": "626-963-2816"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 W FOOTHILL BLVD",
            "city": "GLENDORA",
            "state": "CA",
            "postal_code": "917413364",
            "telephone_number": "626-914-3871",
            "fax_number": "626-963-2816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RAYMUNDO S BAUTISTA, MD, PROF CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-23",
        "last_updated": "2012-08-31",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "RAYMUNDO",
        "authorized_official_middle_name": "SEVILLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "626-914-3871",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CA",
            "license": "A52874",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A528740",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRES. MEDICAL STATE LIC#",
            "identifier": "A52874",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Alexander Ramsey, RN
• Paramjit Kaur Randhawa, BSC
• Randy R Burt, OD Inc.
• Revathy Ranganathan
• Kristen Danielle Rawlings, LMFT
• RBB Healthcare Inc.
• RBB Healthcare Inc.
• Kayla R Recio
• Darryl Reed Jr.
• Leah Fortson Reed, PHD

• Nephrology Physician in Glendora, CA
• Providers in Glendora, CA by specialty
• Nephrology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.