CMS-1500 Box 24J / 33a • NPI
1629101340
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
207Q00000X (CMS 08)
Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)
Box 32 Service Location & ZIP+4
427 CENTRAL AVE, FILLMORE, CA, 93015
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1629101340 (BAUTISTA MEDICAL GROUP SOUTHERN CALIFORNIA, INC.) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1629101340 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | BAUTISTA MEDICAL GROUP SOUTHERN CALIFORNIA, INC. |
| Plain-English Specialty | Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) NUCC Code: 207Q00000X (Family Medicine) |
| Certifying / Licensing Body | American Board of Family Medicine (ABFM) |
| Practice Location Address | 427 CENTRAL AVE, FILLMORE, CA, 93015 |
| Practice Telephone / Fax | Tel: (805) 524-0777 | Fax: (805) 524-0111 |
| Administrative Mailing Address | 427 CENTRAL AVE, FILLMORE, CA, 93015-1329 |
| Enumeration & Last Sync | Enumerated: 2007-03-13 | CMS Record Updated: 2023-01-31 |
| Authorized Official | JOSE BAUTISTA (Internist) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (207Q00000X)
What Does Taxonomy Code 207Q00000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 207Q00000X translates to:
"Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor)"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (BAUTISTA MEDICAL GROUP SOUTHERN CALIFORNIA, INC.)
Typical CPT / Diagnostic Procedures:- Comprehensive Annual Preventive Physical Examination & Cardiometabolic Screening
- Outpatient ECG / EKG Interpretation (CPT 93000) & Ambulatory BP Monitoring
- Point-of-Care HbA1c, Lipid Panel, Urinalysis & BMI Risk Stratification
- Minor Office Procedures: Wound Suturing, Abscess Drainage & Joint Injections
- Adult & Pediatric Immunization Administration (Tetanus/Tdap, Influenza, HPV)
- Metformin, SGLT2 Inhibitors & GLP-1 Receptor Agonists (Type 2 Diabetes)
- Lisinopril, Losartan & Amlodipine (First-Line Hypertension Management)
- Atorvastatin & Rosuvastatin (Cardiovascular Lipid Optimization)
- Nitrofurantoin, Trimethoprim-Sulfamethoxazole & Ciprofloxacin (Outpatient UTIs)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: CA | License: PA15385 | Primary: Secondary |
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: CA | License: A97270 | Primary: Secondary |
207Q00000X — Family MedicinePlain English: Board-Certified Family Medicine Physician (All-Ages Primary Care Doctor) | State: CA | License: A43293 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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