Maria C Bautista MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A41768 Issued in CA

Legal business name

MARIA C BAUTISTA MD INC

Practice address

11878 Avenue of Industry
San Diego, CA 92128-3423

Phone

(858) 722-4779

NPI assigned

Sep 22, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Maria Corazon Bautista, M.D.NPI 1528167723

Title

President

Phone

(858) 722-4779

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

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

• Maria Corazon Bautista, M.D.

  • Internal Medicine Physician
  • San Diego, CA
  • NPI 1528167723
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1582502400000",
    "number": "1215036462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1770",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919441770",
            "telephone_number": "858-722-4779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11878 AVENUE OF INDUSTRY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283423",
            "telephone_number": "858-722-4779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARIA C BAUTISTA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-22",
        "last_updated": "2020-02-24",
        "certification_date": "2020-02-24",
        "status": "A",
        "authorized_official_last_name": "BAUTISTA",
        "authorized_official_first_name": "MARIA",
        "authorized_official_middle_name": "CORAZON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-722-4779",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A41768",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A417680",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Angela Briana Margeson
• Kate Lynn Margheritis, DNP
• Emily Angela Margolin, MD
• Ellen Beth Margolis, PHD
• Maria Belinsky Psychotherapy Group, a Professional Corporation
• Maria Lourdes S Mara MD - a Medical Corp
• Maria Rhi DDS, Professional Dental Corporatoin
• Maria Theresa O Villa, PC
• Dani Maria, PHARM.D.
• Robyn Kim Marian, BCBA

• Internal Medicine Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2020; 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.