Marius Jordan Bautista Agustin, BSN,RN,CCRN
Individual provider Active NPI Critical Care Medicine Registered Nurse · Loma Linda, CA
NPI 1699695296 · NPPES record last updated Jul 16, 2026
Key facts
- NPI
- 1699695296
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Critical Care Medicine Registered Nurse 163WC0200X
- License
- RN9361873 (FL)
- Practice address
- 11201 Benton St
Loma Linda, CA 92357-1000 - Phone
- (909) 825-7084
- NPI assigned
- Jul 16, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | RN9361873 | FL | Yes |
Addresses
Primary practice location
11201 Benton St
Loma Linda, CA 92357-1000
Mailing address
11201 Benton St
Loma Linda, CA 92357-1000
Phone (909) 825-7084
Other providers in Loma Linda, CA
- Stuti Agrawal
- Vikash Agrawal
- Latimer Aguilar
- Samantha Aguilar
- Mildred Greys Aguirre
- James Agustines
- Kwame Boateng Agyeman
- Borhaan Ahmad
- Imdad - Ahmad
- Maleeha Ahmad
All providers in Loma Linda, CA · Critical Care Medicine Registered Nurse in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 16, 2026. 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.