Melissa Bustos
Individual provider Active NPI Physician Assistant · La Puente, CA
NPI 1275902181 · NPPES record last updated Sep 21, 2015
Key facts
- NPI
- 1275902181
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- Practice address
- 1041 Tonopah Ave
La Puente, CA 91744-1752 - Phone
- (909) 680-7471
- NPI assigned
- Sep 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52883 | CA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Yes |
Addresses
Primary practice location
1041 Tonopah Ave
La Puente, CA 91744-1752
Mailing address
1041 Tonopah Ave
La Puente, CA 91744-1752
Other providers in La Puente, CA
- Tatiana Bojorquez Grijalva
- Inthava Bounpraseuth-Hao
- Dina Brown
- Michael Joshua Bugante
- Ashley P. Bullock
- David Butchert
- Ca Home Care LLC
- Jazmin Alina Cabrera Lopez
- Esperanza Cadena
- Albert Richard Calderon I
All providers in La Puente, CA · Physician Assistant in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 21, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.