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BAUTISTA MEDICAL GROUP SOUTHERN CALIFORNIA, INC.
NPI 1629101340
Family Medicine in Fillmore, CA

Active since March 13, 2007CLIA Certified · 2 labs
427 CENTRAL AVE, FILLMORE, CA 93015(805) 524-0777(805) 524-0111 Get Directions Write a Review

NPPES record last updated: January 31, 2023. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: Jan 31, 2023, Sep 19, 2019, Jul 16, 2019 (3 updates tracked since 2019).

About Bautista Medical Group Southern California, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

BAUTISTA MEDICAL GROUP SOUTHERN CALIFORNIA, INC. (NPI 1629101340) is a healthcare organization registered as a family medicine in Fillmore, California and active in the NPI registry since March 2007. The organization holds 2 active CLIA laboratory certificates, maintains a secondary practice location in Oxnard, and lists Jose Luis Bautista, Internist, as its authorized official.

NPPES Registry Identity

NPI1629101340
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameBAUTISTA MEDICAL GROUP SOUTHERN CALIFORNIA, INC.
Location Address427 CENTRAL AVEFillmore, CA 93015
Mailing Address427 Central AveFillmore, CA 93015-1329 · (805) 524-2559 · Fax (805) 524-2596
Phone(805) 524-0777
Fax(805) 524-0111
Organization SubpartNo
Authorized OfficialJose Luis BautistaInternist · (805) 524-2559
Enumeration DateMarch 13, 2007
Last NPPES UpdateJanuary 31, 20233 updates tracked since enumeration
NPPES CertifiedAugust 1, 2022
✔ NPI 1629101340 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Licenses✔ Licensed in CA · A43293✔ Licensed in CA · PA15385✔ Licensed in CA · A97270
Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

427 CENTRAL AVE, Fillmore, CA 93015
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Secondary Practice Location 1

Location 1991 W 7th StOxnard, CA 93030-6757 · Phone (805) 483-7500 · Fax (805) 483-0500

Other Identifiers 1

MedicaidGR0063042CA

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X MULTIPLE SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA 2

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D0998466

Bautista Medical Group Southern California, Inc · Oxnard, CA
Active · expires Apr 15, 2028
CLIA Number05D0998466
Laboratory TypePhysician Office
Certificate Effective DateApril 16, 2026
Certificate Expiration DateApril 15, 2028
Laboratory DirectorJose L. Bautista
Laboratory Phone(805) 483-7500
Laboratory LocationBautista Medical Group Southern California, Inc991 W 7th St, Oxnard, CA 93030
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Certificate of Waiver 05D2170910

Bautista Medical Group Southern California Inc · Fillmore, CA
Active · expires Aug 20, 2027
CLIA Number05D2170910
Laboratory TypePhysician Office
Certificate Effective DateAugust 21, 2025
Certificate Expiration DateAugust 20, 2027
Laboratory DirectorLuis J. Bautista
Laboratory Phone(805) 524-2559
Laboratory LocationBautista Medical Group Southern California Inc427 Central Avenue, Fillmore, CA 93015
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ELIASAR BENJAMIN MACIAS PA
Physician Assistant
427 CENTRAL AVE
FILLMORE, CA 93015
Ventura County (805) 524-2559
QUIK CARE MEDICAL INC
Clinic/Center (Primary Care)
427 CENTRAL AVE
FILLMORE, CA 93015
Ventura County (805) 524-2559
MR. JORGE O BAUTISTA PA
Physician Assistant
427 CENTRAL AVE
FILLMORE, CA 93015
Ventura County (805) 524-2559

Frequently Asked Questions

What is BAUTISTA MEDICAL GROUP SOUTHERN CALIFORNIA, INC.'s NPI number?

The NPI number assigned to this healthcare provider is 1629101340, enumerated as an "organization" on March 13, 2007.

Where is the provider located?

The provider is located at 427 CENTRAL AVE FILLMORE, CA 93015 and the phone number is (805) 524-0777.

What is the provider's specialty?

Family Medicine with taxonomy code 207Q00000X.

What insurance does BAUTISTA MEDICAL GROUP SOUTHERN CALIFORNIA, INC. accept?

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.