CEDRIC M. BAUTISTA M.D., A MEDICAL CORPORATION (NPI# 1124392725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1124392725 |
| Entity Type | Organization |
| Organization Name | CEDRIC M. BAUTISTA M.D., A MEDICAL CORPORATION |
| Practice Address |
1500 S Imperial Ave El Centro CA 92243-4241 |
| Mailing Address |
Po Box 2010 El Centro CA 92244-2010 |
| Practice Telephone | 7603536200 |
| Practice Fax Number | 7603539817 |
| Mailing Telephone | 7603536200 |
| Mailing Fax Number | 7603539817 |
| Enumeration Date | 2012-02-28 |
| Last Update Date | 2012-02-28 |
| Authorized Official Name | CEDRIC M BAUTISTA (OWNER) |
| Authorized Official Telephone | 7603536200 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | A37997 | CA | Allopathic & Osteopathic Physicians |
| Street Address |
1500 S IMPERIAL AVE |
| City | EL CENTRO |
| State | CA |
| Zip Code | 92243-4241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861719817 | Marc Manix | Neurological Surgery | 1500 S Imperial Ave, El Centro, CA 92243-4241 | 2010-04-30 |
| 1063942993 | Manix Medical Inc | Neurological Surgery | 1500 S Imperial Ave, El Centro, CA 92243-4241 | 2017-06-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1346856671 | Ana Lilia Solorio | Health Educator | 1415 Ross Ave., El Centro, CA 92243 | 2020-09-22 |
| 1467073775 | Mabel Janet Castro-ley | Counselor | 22 N 8th St., El Centro, CA 92243 | 2020-04-28 |
| 1831723030 | Guadalupe Heredia | Registered Nurse | 1415 Ross Ave El Centro Ca, El Centro, El Centro, CA 92243 | 2020-02-26 |
| 1851948061 | Hamlet Khachatryan Dds, Inc. | Dentist | 1698 Cruickshank Drive, Suite B, El Centro, CA 92243 | 2019-08-22 |
| 1104478924 | Courtney Barker | Occupational Therapist | 1161 Main St., El Centro, CA 92243 | 2019-07-11 |
| 1891350997 | Amy Nguyen Dao | Nurse Practitioner | 852 Danenberg Drive, El Centro, CA 92243 | 2019-05-03 |
| 1538723622 | Patrick H Dao | Nurse Practitioner | 852 Danenberg Dr., El Centro, CA 92243 | 2019-04-24 |
| 1114494861 | Alba Care Mental Health Serrvices | Counselor | 1498 Main Street, El Centro, CA 92243 | 2018-10-31 |
| 1922503085 | Joanne P. Goode | Nurse Practitioner | El Centro Health Clinic, 651 Wake Avenue, El Centro, CA 92243 | 2018-03-29 |
| Find all providers in zip 92243 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568842128 | University Surgical Group Inc | Surgery | 2618 Thomas Dr, 800, El Centro, CA 92243-7518 | 2015-06-08 |
| 1306119680 | Seung S Gwon M D Inc | Surgery | 1699 W Main St Ste D, El Centro, CA 92243-2235 | 2012-02-16 |
| 1588896807 | Vein Clinic Inc | Surgery | 1699 W Main St, Suite E, El Centro, CA 92243-2235 | 2009-08-20 |
| 1063497097 | Hank C. Hill | Surgery | 1665 South Imperial Avenue, Suite B, El Centro, CA 92243 | 2005-12-13 |
| 1730171059 | Seung S. Gwon | Surgery | 1671 W Main St Ste B, El Centro, CA 92243-5420 | 2005-08-22 |
| 1700172913 | James A Pollack Md LLC | Surgery | 1594 S Imperial Ave, El Centro, CA 92243-4241 | 2011-06-26 |
| 1669680260 | Charles R. Humphrey, M.d.,inc | Surgery | 1415 Ross Ave, El Centro, CA 92243-4306 | 2007-05-18 |
| 1447355508 | Charles Rogers Humphrey | Surgery | 1415 Ross Ave, El Centro, CA 92243-4306 | 2006-09-13 |
| 1205845807 | James A. Pollack | Surgery | 2061 Ross Ave, Suite A, El Centro, CA 92243-3687 | 2006-08-05 |
| 1487627212 | Harold Christopher Barnes | Surgery | 1665 South Imperial Avenue, Suite B, El Centro, CA 92243 | 2006-02-10 |
| Find all providers in EL CENTRO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.