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ROBERT GERONIMO BAUTISTA — OIG Excluded Provider (SAN DIEGO, CA, 1128b4)

ROBERT GERONIMO BAUTISTA — OIG Excluded Provider (SAN DIEGO, CA, 1128b4) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: ROBERT GERONIMO BAUTISTA; Type: Individual; Provider category: SKILLED NURSING FAC.

NameROBERT GERONIMO BAUTISTA
TypeIndividual
Provider categorySKILLED NURSING FAC
SpecialtyNURSE/NURSES AIDE
CitySAN DIEGO
StateCA
ZIP92112
Exclusion authority1128b4
Exclusion reasonLicense revocation, suspension, or surrender
Exclusion date2006-12-20
SourceHHS-OIG LEIE

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