Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Daisy Ibanez Bautista, MD

Individual provider Pediatrics Physician · NPI 1306856992

Dr. Daisy Ibanez Bautista, MD is a Family Practice in Los Angeles, California. Qualified in 1969, 57 years ago. Practices with California Mobile Medical Group Inc, a 19-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
57
Licensed in
CA
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1930 Wilshire Blvd #803
Los Angeles, CA 90057-3605
Phone: (213) 483-3968
Fax: (213) 483-3495
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence A36896 (CA)
Pediatrics Physician Taxonomy 208000000X · Licence A368969 (CA)
General Practice Physician Taxonomy 208D00000X · Licence A368969 (CA)

Record details

NPI number1306856992
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorYes
NPI enumeratedAugust 8, 2006
Last updated in NPPESJuly 23, 2024
Certification dateJuly 23, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Also practisesGENERAL PRACTICE
Medical schoolOTHER
Graduated 1969 (57 years in practice)
Group practice California Mobile Medical Group Inc — 19 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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