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BAUTISTA, JOSE LUZA III       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 274 W. BADILLO ST.
COVINA CA 91723

Address last updated on 3/5/2012
Phone #: (626) 665-6704
Fax #:
County: NOT OKLAHOMA
License: 22330
Dated: 4/10/2001
Expires: 4/1/2013
License Type: Medical Doctor
Specialty: General Surgery
Status: Inactive
Status Class: Expired License
Restricted to:
Registered to Dispense: NO
Medical School: Univ Of The Philippines Sys, Coll Of Med, Manila, Philippines
Graduated: 3 / 1972
CME Year: 2013
Pending and/or Past Disciplinary Actions: No Disciplinary Action Taken.
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications: AMERICAN BOARD OF SURGERY
New Patients: Contact licensee
Medicaid: Contact licensee
Medicare: Contact licensee
   
HMO/PPO: None listed
Hospital Privileges: None listed
Locations: Hours: Languages:
274 W. BADILLO ST.
COVINA CA 91723

Phone #: (626) 665-6704
Fax #:
Mon:
Tue:
Wed:
Thu:
Fri:
Sat:
Sun:

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