ROGER BAUTISTA (NPI# 1902888084) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902888084 |
| Entity Type | Individual |
| Full Name | ROGER BAUTISTA |
| Credential | D.O. |
| Practice Address |
115 Mall Dr Hanford CA 93230-5786 |
| Mailing Address |
1601 Cummins Dr Ste D Modesto CA 95358-6411 |
| Practice Telephone | 5595829000 |
| Mailing Telephone | 5108517423 |
| Enumeration Date | 2005-11-15 |
| Last Update Date | 2020-03-16 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207P00000X | Emergency Medicine | 70711 | GA | Allopathic & Osteopathic Physicians |
| Y | 207P00000X | Emergency Medicine | 20A9319 | CA | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | 42078 | CO | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 9501 Farrell Rd, Fort Belvoir, VA 220605901 | 7038050599 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063941300 | Roger Bautista | Behavior Technician | 10174 Old Grove Rd, San Diego, CA 92131-1652 | 2017-06-09 |
| Street Address |
115 MALL DR |
| City | HANFORD |
| State | CA |
| Zip Code | 93230-5786 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669080511 | Daniel James Garland | Nurse Anesthetist, Certified Registered | 115 Mall Dr, Hanford, CA 93230-5786 | 2020-07-16 |
| 1184245896 | Carl Eric Galeon | Nurse Anesthetist, Certified Registered | 115 Mall Dr, Hanford, CA 93230-5786 | 2020-05-04 |
| 1265060982 | Cody Luallen | Pharmacist | 115 Mall Dr, Hanford, CA 93230-5786 | 2020-03-29 |
| 1043843741 | Michelle Marie Mertens | Nurse Anesthetist, Certified Registered | 115 Mall Dr, Hanford, CA 93230-5786 | 2020-02-20 |
| 1609417161 | Marisol Tienda | Nurse Practitioner | 115 Mall Dr, Hanford, CA 93230-5786 | 2019-10-04 |
| 1568019826 | Michelle Renee Hernandez | Nurse Practitioner | 115 Mall Dr, Hanford, CA 93230-5786 | 2019-08-21 |
| 1720634652 | Liviu Amariei | Nurse Anesthetist, Certified Registered | 115 Mall Dr, Hanford, CA 93230-5786 | 2019-08-15 |
| 1285293969 | Kevin Tatum | Registered Nurse | 115 Mall Dr, Hanford, CA 93230-5786 | 2019-06-06 |
| 1033777164 | Shirley Zhao | Nurse Anesthetist, Certified Registered | 115 Mall Dr, Hanford, CA 93230-5786 | 2019-06-04 |
| 1336705763 | Ava Wong | Physician Assistant | 115 Mall Dr, Hanford, CA 93230-5786 | 2019-05-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740889518 | Jeremy Dane Baker | Hearing Instrument Specialist | 1413-b Bailey Dr., Hanford, CA 93230 | 2020-10-22 |
| 1891392643 | Matthew Thomas Williams | Physician Assistant | Adventist Health Hanford, 115 Mall Dr., Hanford, CA 93230 | 2020-10-05 |
| 1730795667 | Mercedes Zaragoza | Behavior Technician | 520 1ab, W. Lacey Blvd., Hanford, CA 93230 | 2020-09-16 |
| 1659989077 | Anmarie Torres | Behavior Technician | 520 1a&b W Lacey Blvd, Hanford, CA 93230 | 2020-07-22 |
| 1326506965 | Natalie Rodriguez Mejia | Marriage & Family Therapist | 1393 Bailey Drive St, Hanford, CA 93230 | 2019-03-02 |
| 1972094597 | Mariah Michelle Davila | Licensed Psychiatric Technician | 1529 W Sidonia St, Hanford, CA 93230 | 2018-05-21 |
| 1871011072 | Amanda Leann Perez | Counselor | 629 N. Irwin Street, Hanford, CA 93230 | 2017-09-07 |
| 1336667906 | Nicole Reyne Mcgowan | Case Manager/Care Coordinator | 700 N. Irwin Street, Hanford, CA 93230 | 2017-09-05 |
| 1932643251 | Diana Tran Nguyen | Midwife | 1122 N Harris St Ste 104, Hanford, CA 93230 | 2016-12-05 |
| 1770032997 | Costco Wholesale Corporation | Eyewear Supplier (Equipment, not the service) | 2395 E. Lacey Blvd, Hanford, CA 93230 | 2016-09-29 |
| Find all providers in zip 93230 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063649523 | Jaclyn Marie Wood | Emergency Medicine | 115 Mall Dr, Hanford, CA 93230-5786 | 2009-06-11 |
| 1508938465 | Cep America - California | Emergency Medicine | 115 Mall Dr, Hanford, CA 93230-5786 | 2006-11-15 |
| 1043253909 | Scott Bowen | Emergency Medicine | 450 Greenfield Ave, Emergency Dept., Hanford, CA 93230-3513 | 2006-06-14 |
| 1417998808 | Edward Wargo | Emergency Medicine | 1025 N Douty St, Emergency Dept., Hanford, CA 93230-3722 | 2006-06-09 |
| 1679513733 | Evan Hirsch | Emergency Medicine | 1025 N Douty St, Emergency Department, Hanford, CA 93230-3722 | 2006-06-07 |
| 1871533851 | Fritz Leidig | Emergency Medicine | 1025 N Douty St, Emergency Department, Hanford, CA 93230-3722 | 2006-06-07 |
| 1912947102 | Lawrence Jellinek | Emergency Medicine | 1025 N Douty St, Emergency Department, Hanford, CA 93230-3722 | 2006-06-07 |
| 1962441758 | Jared D. Gerstein | Emergency Medicine | 1025 N Douty St, Emergency Department, Hanford, CA 93230-3722 | 2006-06-06 |
| 1427097229 | David A. Smith | Emergency Medicine | 1025 N Douty St, Emergency Department, Hanford, CA 93230-3722 | 2006-06-06 |
| 1215981535 | Daniel B. Brown | Emergency Medicine | 1025 N Douty St, Emergency Department, Hanford, CA 93230-3722 | 2006-05-20 |
| Find all providers in HANFORD | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.