BAUTISTA MEDICAL GROUP NPI 1487634317

NPI Information

NPI: 1487634317
Provider Name: BAUTISTA MEDICAL GROUP
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
:
Address: 2505 MERCED ST
FRESNO, CA
ZIP 93721
Phone: (559) 445-0391

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NPI Details

BAUTISTA MEDICAL GROUP is a family medicine in Fresno, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. BAUTISTA MEDICAL GROUP NPI is 1487634317. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

2505 MERCED ST
FRESNO, CA
ZIP 93721-811
Phone: (559) 445-0391
Fax: (559) 445-0316

The provider's authorized official is Jose Luis Bautista .
The authorized official title is Medical Director and has the following contact phone number (559) 445-0391.

The enumeration date for this NPI number is 1/18/2006 and was last updated on 9/11/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	License Number	License State	Primary
1	363A00000X	Physician Assistant	PA16817	CALIFORNIA	No
2	208000000X	Pediatrics	A84959	CALIFORNIA	No
3	207R00000X	Internal Medicine	A43293	CALIFORNIA	No
4	363A00000X	Physician Assistant	PA13143	CALIFORNIA	No
5	208D00000X	General Practice	A97270	CALIFORNIA	No
6	207Q00000X	Family Medicine			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	ZZZ3862Z	OTHER	CALIFORNIA	BLUE SHIELD
2	GR0063040	OTHER	CALIFORNIA	MEDI-CAL

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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