Edith Carpio Bautista, MD
Individual provider Active NPI Anesthesiology Physician · Mather, CA
NPI 1124092358 · NPPES record last updated Aug 20, 2007
Key facts
- NPI
- 1124092358
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- G85461 (CA)
- Practice address
- 10535 Hospital Way
VA Sacramento Medical Center, Surgical Services
Mather, CA 95655-4200 - Phone
- (916) 366-5410
- NPI assigned
- Feb 14, 2006
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G85461 | CA | MD | Anesthesiology Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | G85461 | CA | Yes |
Addresses
Primary practice location
10535 Hospital Way
VA Sacramento Medical Center, Surgical Services
Mather, CA 95655-4200
Mailing address
7775 S Oak Way
Sacramento, CA 95831-4453
Phone (916) 427-4424
Other providers in Mather, CA
- Jon Baker
- Sheldon S Ball
- Charles Arthur Barnett
- Rebecca Barone
- Bruce Baseflug
- Kathleen Baynes
- Anahita Behrouzi
- David Bell
- Sharmel Jordan Bender
- Ciara E Bennett
All providers in Mather, CA · Anesthesiology Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 20, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.