DAISY I .BAUTISTA, MD, A MEDICAL CORPORATION
Osteopathic Medicine at Wilshire Blvd, Los Angeles, CA

License number
California A36896
Category
Medical Practice
Type
Pediatrics
License number
California A36896
Category
Osteopathic Medicine
Type
General Practice
Owner
Name: DR. DAISY IBANEZ BAUTISTA M.D.
Title: PRESIDENT OWNER
Phone: (213) 483-3968
Address
Address
1930 Wilshire Blvd STE. 803, Los Angeles, CA 90057
National Provider ID: 1689691537
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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DAISY I. BAUTISTA, MD, A MEDICAL CORPORATION

Los Angeles, CA

Status:
Inactive
Doing business as:
Daisy I. Bautista, M.D., A Medical Corporation
Registration:
Sep 12, 2006
Addresses:
1930 Wilshire Blvd SUITE 803, Los Angeles, CA 90057 (Physical)
328 S Alvarado St, Los Angeles, CA 90057
State ID:
C2903746
Business type:
Articles of Incorporation
President, President:
Daisy I. Bautista President, President, inactive
Agent:
Daisy Ibanez Bautista,Los Angeles, CA 90057 (Physical)

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