Active NPI
Melissa Bustos
- Physician Assistant
- La Puente, CA
National Provider Identifier
1275902181
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 1041 Tonopah Ave
La Puente, CA 91744-1752 - Phone
- (909) 680-7471
- NPI assigned
- Sep 21, 2015
- Last updated
- Sep 21, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
1041 Tonopah Ave
La Puente, CA 91744-1752
Mailing address
1041 Tonopah Ave
La Puente, CA 91744-1752
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 52883 | CA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1442793600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442793600000",
"number": "1275902181",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1041 TONOPAH AVE",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917441752"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1041 TONOPAH AVE",
"city": "LA PUENTE",
"state": "CA",
"postal_code": "917441752",
"telephone_number": "909-680-7471"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUSTOS",
"first_name": "MELISSA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-09-21",
"last_updated": "2015-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in La Puente, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.