Individual provider · Type 1 NPI

Marvin Icban Bautista, DC

Chiropractor · San Bruno, CA

NPI number 1215012778 Active

Practice location

931 San Bruno Ave W Rm 7
San Bruno, CA 94066-3435

Call (650) 225-0500 Map

Fax (650) 225-0510

Mailing address

130 Yolo Ct
San Bruno, CA 94066-2555

Specialties and licenses

TaxonomyCodeLicense
Chiropractor Primary 111N00000XDC28034 (CA)

Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.

3 other providers at this address

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About NPI 1215012778

Marvin Icban Bautista, DC's National Provider Identifier is 1215012778, issued on Oct 25, 2006. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in San Bruno, CA. The record was last updated on Jul 8, 2007.