MEDICARE: BATONGMALAQUE MEDICAL CORPORATION

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
1	213ES0103X	Foot & Ankle Surgery Podiatrist	E3728	CA
2	225100000X	Physical Therapist	PT15084	CA

General Provider Information

NPI Number	:	1043269608
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BATONGMALAQUE MEDICAL CORPORATION

Provider Business Mailing Address
First Line	:	11631 VICTORY BLVD
Second Line	:	SUITE 201
City	:	N HOLLYWOOD
State	:	CA
Zip	:	91606-3572
Country	:	US
Telephone Number	:	818-760-9538
Fax Number	:	818-760-9539

Provider Business Practice Location Address
First Line	:	11631 VICTORY BLVD
Second Line	:	SUITE 201
City	:	N HOLLYWOOD
State	:	CA
Zip	:	91606-3572
Country	:	US
Telephone Number	:	818-760-9538
Fax Number	:	818-760-9539

Authorized Official
Title or Position	:	CEO
Name	:	MRS. JENNY BATONGMALAQUE
Credential	:	M.D.
Telephone Number	:	818-760-9538

Provider Enumeration Date	:	05/09/2006
Last Update Date	:	09/11/2025

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