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Marvin Icban Bautista, DC
Chiropractor in San Bruno, California
NPI 1215012778

Marvin Icban Bautista is a Chiropractor based in San Bruno, CA. Marvin Icban Bautista practices in San Bruno, CA and has the professional credentials of DC. The NPI Number for Marvin Icban Bautista is 1215012778 and holds a License No. DC28034 (California).

The current practice location address for Marvin Icban Bautista is 931 San Bruno Ave W Rm 7, San Bruno, CA and can be reached out via phone at 650-225-0500 and via fax at 650-225-0510.

Location: 931 San Bruno Ave W Rm 7, San Bruno, CA, 94066-2555
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215012778
Provider Name
Marvin Icban Bautista
Credential
DC
Provider Entity Type
Individual
Gender
Male
Address
931 San Bruno Ave W Rm 7, San Bruno, CA, 94066-2555
Phone Number
650-225-0500
Fax Number
650-225-0510
Provider Enumeration Date
10/25/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
931 San Bruno Ave W Rm 7
City
San Bruno
State
California
Zip
94066-3435
Phone Number
650-225-0500
Fax Number
650-225-0510
person
Provider Business Mailing Address Details
Address
931 San Bruno Ave W Rm 7
City
San Bruno
State
California
Zip
94066-3435
Phone Number
650-225-0500
Fax Number
650-225-0510
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
DC28034 (California)
Definition
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.
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