Organization Active NPI

Jerrold C Bustos MD, Inc

  • Anesthesiology Physician
  • Glendale, CA
National Provider Identifier
1548551930
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
A85842 Issued in CA
Legal business name
JERROLD C BUSTOS MD, INC
Practice address
5700 San Fernando Rd
Glendale, CA 91202-2104
Phone
(818) 637-7766
Fax
(818) 956-1706
NPI assigned
Apr 20, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jerrold C Bustos, MD
Title
President
Phone
(949) 588-2190

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207L00000X A85842 CA Primary

Addresses

Primary practice location

5700 San Fernando Rd
Glendale, CA 91202-2104

Mailing address

5 Holland Ste 101
Irvine, CA 92618-2568
Phone (949) 588-2190

National Provider Directory

National Provider Directory
Tax ID family
Jerrold C Bustos MD Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1303257600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1303257600000",
    "number": "1548551930",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HOLLAND STE 101",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926182568",
            "telephone_number": "949-588-2190",
            "fax_number": "949-588-2199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 SAN FERNANDO RD",
            "city": "GLENDALE",
            "state": "CA",
            "postal_code": "912022104",
            "telephone_number": "818-637-7766",
            "fax_number": "818-956-1706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERROLD C BUSTOS MD, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-20",
        "last_updated": "2011-04-20",
        "status": "A",
        "authorized_official_last_name": "BUSTOS",
        "authorized_official_first_name": "JERROLD",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "949-588-2190",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "CA",
            "license": "A85842",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.