KRISTINE BUSTOS


Address: 1200 N Pacific Ave Ste 104, Glendale, CA 91202
Phone: 8189569913

KRISTINE BUSTOS (NPI# 1144724436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1144724436
Entity Type Individual
Full Name KRISTINE BUSTOS
Credential NP-C
Practice Address 1200 N Pacific Ave Ste 104
Glendale
CA 91202
Mailing Address 1200 N Pacific Ave Ste 104
Glendale
CA 91202-3804
Practice Telephone 8189569913
Mailing Telephone 8189569913
Enumeration Date 2018-03-21
Last Update Date 2018-08-22
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 363LF0000X Nurse Practitioner
Specialization: Family
95008705 CA Physician Assistants & Advanced Practice Nursing Providers
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
819234 CA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 1200 N PACIFIC AVE STE 104
City GLENDALE
State CA
Zip Code 91202

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NPI Name Taxonomy Address Enumeration
1528538857 Forever Active Cbas Clinic/Center 1111 W Glenoaks Blvd, Glendale, CA 91202 2018-11-29
1295159614 Kevin Lew Dentist 1122 N. Brand Blvd. Suite 102, Glendale, CA 91202 2014-02-05
1568709350 Helen Chalakians Counselor 525 Glenwood Rd, Glendale, CA 91202 2013-01-14
1316216161 Teresa Eligio Nurse Practitioner 857 Grant Ave, Glendale, CA 91202 2011-12-23
1033486139 Advance Hospice Care, Inc. Home Health 1209 N. Central Ave Suite 204, Glendale, CA 91202 2011-11-18
1659518785 Sarine Davityan Marriage & Family Therapist 1010 N Central Ave # 310, Glendale, CA 91202 2009-01-12
1760635619 Tatiana Mikaelian Dds Inc Dentist 1209 N. Central Ave, #203, Glendale, CA 91202 2008-10-23
1669624219 Marine Demirjian Allergy & Immunology 1131 N Pacific Ave, Glendale, CA 91202 2008-10-15
1902055783 Lousine Vahagn Kirakosian Dentist 125 E. Glenoaks Blvd., Suite 103, Glendale, CA 91202 2008-09-16
1568631760 Faranak Hosseinkhani Physical Therapist 512 W.stocker St, Apt # 6, Glendale, CA 91202 2008-02-21
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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1619498128 Anna Krakowski Nurse Practitioner 7137 70th St # C, Glendale, NY 11385-7245 2017-07-05
1023567435 Victoria Bowers Nurse Practitioner 6808 N Dysart Rd Ste 136, Glendale, AZ 85307-2232 2016-09-26
1437474129 Paula Kay Scoggins Nurse Practitioner 4221 W Villa Rita Dr, Glendale, AZ 85308-2514 2010-04-06
1205398120 Christy L Hogue Nurse Practitioner 6677 W Thunderbird Rd Ste E, Glendale, AZ 85306-3722 2019-04-01
1518494020 John Edgar Alan Hammonds Nurse Practitioner 5620 W Thunderbird Rd Ste F1, Glendale, AZ 85306-4652 2017-05-15
1750820478 Mns Medical Group Nurse Practitioner 1110 Sonora Ave, Glendale, CA 91201-1952 2017-02-14
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Competitor

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City GLENDALE
Zip Code 91202

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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