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General NPI Number Information
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NPI Number | 1518247188
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Entity Type | Individual
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Provider Name | SALVE ROMASANTA BAUTISTA NP
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Gender | Female
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Dates
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Enumeration Date | 08/26/2011
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Last Update Date | 08/26/2011
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Provider Practice Location Address
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Address Line | 12900 PARK PLAZA DR
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City | CERRITOS
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State | CA
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Zip | 90703-9329
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Country | US
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Telephone | 562-741-4421
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Fax | 562-741-4479
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Provider Business Mailing Address
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Address Line | 13600 S AINSWORTH ST
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City | GARDENA
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State | CA
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Zip | 90247-2122
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Country | US
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Telephone | 310-972-8368
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Fax | 310-329-9849
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 19786
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License Number State | CA
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