Individual provider · NPI-1

Jessica Montalban Bautista, DO, MS

Family Medicine · Parker, CO

NPI number1629655006
StatusActive
Last updated in NPPESNov 13, 2024

Details

NPI
1629655006
Entity type
Individual (NPI-1)
Name
Jessica Montalban Bautista
Credential
DO, MS
Sex
Female
Sole proprietor
Yes
Enumeration date
Mar 24, 2021
Certification date
Nov 13, 2024
Last updated
Nov 13, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family MedicineDR.0069284COYes
390200000X Student in an Organized Health Care Education/Training Program––

Practice location

19641 E Parker Square Dr Ste A
Parker, CO 80134-7397

Phone 303-840-3800 · Fax 303-840-8442

Mailing address

19641 E Parker Square Dr Ste A
Parker, CO 80134-7397

Phone 303-840-3800 · Fax 303-840-8442

Other practice locations

1501 S Potomac St
Aurora, CO 80012-5411

Phone 303-695-2600

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