Cristobal Cristian Bautista, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86059164 Issued in CA

Practice address

79125 Corporate Center Dr
#5644
La Quinta, CA 92253-9998

Phone

(760) 485-8408

NPI assigned

Nov 19, 2024

Last updated

Jan 23, 2025By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1731974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1114742632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5644",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922485644",
            "telephone_number": "760-485-8408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79125 CORPORATE CENTER DR",
            "address_2": "#5644",
            "city": "LA QUINTA",
            "state": "CA",
            "postal_code": "922539998",
            "telephone_number": "760-485-8408"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "44095 Calico Cir",
            "address_purpose": "LOCATION",
            "city": "LA Quinta",
            "state": "CA",
            "postal_code": "922534821",
            "country_code": "US",
            "telephone_number": "760-485-8408",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUTISTA",
        "first_name": "CRISTOBAL",
        "middle_name": "CRISTIAN",
        "credential": "RD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-19",
        "last_updated": "2025-01-23",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "CA",
            "license": "86059164",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Megan Baikie, MD
• Christopher J Baker, PA
• Sophia M Ballinas
• Beth Anne Barnett
• Brandon Dale Baty, PHARMD
• Mark J Bayer, M.D.
• BB Medical Group, PC (Baikie Bianchi Family Medicine)
• Ronald Ned Beams, M.D.
• Philip Becker, D.O.
• Angelica Paola Beltran-Renteria, LCSW

• Registered Dietitian in La Quinta, CA
• Providers in La Quinta, CA by specialty
• Registered Dietitian in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.