SOFIA CARMEN BUSTILLO (NPI# 1275144313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275144313 |
| Entity Type | Individual |
| Full Name | SOFIA CARMEN BUSTILLO |
| Practice Address |
1709 Coral Pl Seal Beach CA 90740-5712 |
| Practice Telephone | 5625885143 |
| Mailing Telephone | 5625885143 |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-12 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1709 CORAL PL |
| City | SEAL BEACH |
| State | CA |
| Zip Code | 90740-5712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013564608 | Betty Lou Halloran | Technician | 1320 Kenwood Rd 158g, Seal Beach, CA 90740 | 2019-08-20 |
| 1235794975 | Elizabeth Irene Williams | Behavior Technician | 30002 Dow Ave #122, Tustin, CA 90740 | 2019-05-08 |
| 1679994834 | Alexis Worth | Nurse Practitioner | 1305 Catalina Ave., Seal Beach, CA 90740 | 2013-12-13 |
| 1386074128 | Santa Ana Hospice Inc | Hospice Care, Community Based | 610 Pacific Coast Hwy Ste 211, Seal Beach, CA 90740 | 2013-11-14 |
| 1902242019 | Bernard Georges Gantes | Dentist | 2999 Westminster, Suite 108, Seal Beach, CA 90740 | 2013-05-15 |
| 1144592064 | Brooke Ashley Pancer | Dentist | 2999 Westminster Blvd Seal Beach Dental Implants, Seal Beach, CA 90740 | 2012-02-08 |
| 1003187808 | Justin Cheongsiatmoy | Psychiatry & Neurology | 1301 Kenwood Road, Suite 159b, Seal Beach, CA 90740 | 2012-01-25 |
| 1386912830 | A Peace of Mind Home Care LLC | In Home Supportive Care | 1050 Electric Ave, Suite 308-1, Seal Beach, CA 90740 | 2011-12-12 |
| 1770888430 | Kathleen Cleary Adamovic | Marriage & Family Therapist | 500 Pacific Coast Highway, Suite 214, Seal Beach, CA 90740 | 2011-01-11 |
| 1710218177 | Misty Oppenheim-leaf | Behavioral Analyst | 200 Marina Drive, Suite C, Seal Beach, CA 90740 | 2010-01-26 |
| Find all providers in zip 90740 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760647853 | Lauren N Swanson | Physician Assistant | 1198 Pacific Coast Hwy, Suite I, Seal Beach, CA 90740-6251 | 2008-07-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760089437 | Karine Harutyunyan | Physician Assistant | 500 E Colorado St Ste 101, Glendale, CA 91205-1607 | 2020-10-06 |
| 1437756228 | Kale Burket | Physician Assistant | Bldg 523, S 8th St, El Centro, CA 92243 | 2020-10-05 |
| 1548867666 | Heba Marzouk Al-shoubaki | Physician Assistant | 633 S Pepper St, Anaheim, CA 92802-1459 | 2020-10-01 |
| 1275140550 | Lisa Lynn Passalacqua | Physician Assistant | 431 7th St, Norco, CA 92860-1671 | 2020-09-30 |
| 1144833989 | Trisha Taylor | Physician Assistant | 10399 Tivoli Way, Yucaipa, CA 92399-6017 | 2020-08-30 |
| 1457963944 | Harlan William Monahan | Physician Assistant | 5210 Del Rio Rd, Sacramento, CA 95822-2519 | 2020-08-18 |
| 1124638663 | Gayaneh Gharakhani | Physician Assistant | 1323 E Broadway Apt 110, Glendale, CA 91205-4018 | 2020-08-07 |
| 1144830183 | Loc Bao Tran | Physician Assistant | 8937 Emerson Pl, Rosemead, CA 91770-2813 | 2020-08-04 |
| 1558997957 | Sarah Lubinsky | Physician Assistant | 1511 Montana Ave, Santa Monica, CA 90403-1891 | 2020-03-17 |
| 1316573843 | Roberto Emiliano Meraz Nunez | Physician Assistant | 6642 Fulton Ave, Van Nuys, CA 91401-1312 | 2020-03-16 |
| Find all providers with the same taxonomy | ||||
| City | SEAL BEACH |
| Zip Code | 90740 |
Please comment or provide details below to improve the information on SOFIA CARMEN BUSTILLO.
| 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.