Healthcare Provider Details

I. General information

NPI: 1942119870
Provider Name (Legal Business Name): JUAN JORGE BAUTISTA CATALAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2026
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8300 CAPPS AVE
NORTHRIDGE CA
91324-4729
US

IV. Provider business mailing address

8300 CAPPS AVE
NORTHRIDGE CA
91324-4729
US

V. Phone/Fax

Practice location:
  • Phone: 213-357-8163
  • Fax: 818-279-6305
Mailing address:
  • Phone: 213-357-8163
  • Fax: 818-279-6305

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95183990
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: