Active NPI
Alejandro Antonio Bautista, M.D.
- Developmental - Behavioral Pediatrics Physician
- Indio, CA
National Provider Identifier
1922182211
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Developmental - Behavioral Pediatrics Physician
- License
- G70233
- Practice address
- 81-715 Dr. Carreon Blvd
Ste B1
Indio, CA 92201-5518 - Phone
- (760) 347-1850
- Fax
- (760) 347-8337
- NPI assigned
- Oct 24, 2006
- Last updated
- Apr 9, 2012
- 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 |
|---|---|---|---|---|
| Developmental - Behavioral Pediatrics Physician | 2080P0006X | G70233 | CA | Primary |
Addresses
Primary practice location
81-715 Dr. Carreon Blvd
Ste B1
Indio, CA 92201-5518
Mailing address
81-719 Dr. Carreon Blvd
Ste a
Indio, CA 92201-5518
Phone (760) 342-8898
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)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G70233 | CA | MD | Developmental - Behavioral Pediatrics Physician |
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1333929600000",
"number": "1922182211",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "81-719 DR. CARREON BLVD",
"address_2": "STE A",
"city": "INDIO",
"state": "CA",
"postal_code": "922015518",
"telephone_number": "760-342-8898",
"fax_number": "760-342-9457"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "81-715 DR. CARREON BLVD",
"address_2": "STE B1",
"city": "INDIO",
"state": "CA",
"postal_code": "922015518",
"telephone_number": "760-347-1850",
"fax_number": "760-347-8337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BAUTISTA",
"first_name": "ALEJANDRO",
"middle_name": "ANTONIO",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2012-04-09",
"status": "A"
},
"taxonomies": [
{
"code": "2080P0006X",
"taxonomy_group": "",
"desc": "Pediatrics, Developmental - Behavioral Pediatrics",
"state": "CA",
"license": "G70233",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Indio, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.