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NPI Code Detail

MEDICARE: LUIS BAYONA JR.

MEDICARE: LUIS BAYONA JR.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1366387649
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUIS BAYONA JR.
Provider Business Mailing Address
First Line : 202 N 8TH ST
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-2302
Country : US
Telephone Number : 442-265-1525
Fax Number :
Provider Business Practice Location Address
First Line : 202 N 8TH ST
Second Line :
City : EL CENTRO
State : CA
Zip : 92243-2302
Country : US
Telephone Number : 442-265-1525
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/22/2026
Last Update Date : 04/22/2026

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Directions to “ LUIS BAYONA JR. ” Practice Location

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