Provider Demographics
NPI:1215184478
Name:BAYLESS, CATHY (ATMT)
Entity Type:Individual
Prefix:
First Name:CATHY
Middle Name:
Last Name:BAYLESS
Suffix:
Gender:F
Credentials:ATMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14608 RIVERSIDE DR.
Mailing Address - Street 2:
Mailing Address - City:APPLE VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92307
Mailing Address - Country:US
Mailing Address - Phone:760-953-5800
Mailing Address - Fax:760-961-8500
Practice Address - Street 1:20601 US HIGHWAY 18
Practice Address - Street 2:SUITE 153
Practice Address - City:APPLE VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92307-3567
Practice Address - Country:US
Practice Address - Phone:760-953-5800
Practice Address - Fax:760-961-8500
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2008-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist