Active NPI
Christopher C Bautista
- Podiatrist
- Chino, CA
National Provider Identifier
1235230236
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- E4176
- Practice address
- 5343 Riverside Dr
Chino, CA 91710-4252 - Phone
- (909) 591-4035
- Fax
- (909) 591-4112
- NPI assigned
- Sep 25, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | E4176 | CA | Primary |
Addresses
Primary practice location
5343 Riverside Dr
Chino, CA 91710-4252
Mailing address
5343 Riverside Dr
Chino, CA 91710-4252
Phone (909) 591-4035
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5238870001 | Other | CA | MEDICARE NSC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E4176 | CA | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1221091200000",
"number": "1235230236",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5343 RIVERSIDE DR",
"city": "CHINO",
"state": "CA",
"postal_code": "917104252",
"telephone_number": "909-591-4035",
"fax_number": "909-591-4112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5343 RIVERSIDE DR",
"city": "CHINO",
"state": "CA",
"postal_code": "917104252",
"telephone_number": "909-591-4035",
"fax_number": "909-591-4112"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA",
"first_name": "CHRISTOPHER",
"middle_name": "C",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-25",
"last_updated": "2008-09-11",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "CA",
"license": "E4176",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE NSC",
"identifier": "5238870001",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Chino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.