NPIMap

Individual provider Active NPI

Steven Kalani Sinfuego Bustamante, MD

  • Family Medicine Physician
  • Pomona, CA
National Provider Identifier
1730769100
Registry record updated Aug 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A193132 Issued in CA
Practice address
1501 E Holt Ave
Pomona, CA 91767-5823
Phone
(909) 623-3600
Fax
(909) 623-3383
NPI assigned
Apr 10, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X A193132 CA Primary

Addresses

Primary practice location

1501 E Holt Ave
Pomona, CA 91767-5823

Mailing address

1501 E Holt Ave
Pomona, CA 91767-5823
Phone (909) 623-3600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240903001920 CA Practitioner - Family Practice 0244779361 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Unicare Community Health Center, Inc.Group PAC ID 8426369067, 64 clinicians

Practice addresses (Care Compare)

1501 E Holt Ave
Suite a
Pomona, CA 91767-5823
Phone (909) 623-3600

437 N Euclid Ave
Ontario, CA 91762-3456
Phone (909) 988-2555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A193132CAMDFamily Medicine Physician

Practice roles (3 of 4)

OrganizationSpecialtyStatusNew patients
Unicare Community Health Center, Inc. CurrentSince Aug 19, 2024 Accepting new patients
Unicare Community Health Center Inc Current Accepting new patients
Unicare Community Health Center Inc CurrentSince Aug 19, 2024 Accepting new patients

Locations

107 N McKinley St
Corona, CA 92879
Phone (951) 358-0141

1151 E Walnut St
Ontario, CA 91761
Phone (909) 467-0797

437 N Euclid Ave
Ontario, CA 91762
Phone (909) 749-1835

1501 E Holt Ave
Ste A
Pomona, CA 91767
Phone (909) 623-3600

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Organizations & group practices 19

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724112000000",
    "number": "1730769100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1501 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675823",
            "telephone_number": "909-623-3600",
            "fax_number": "909-623-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 E HOLT AVE",
            "city": "POMONA",
            "state": "CA",
            "postal_code": "917675823",
            "telephone_number": "909-623-3600",
            "fax_number": "909-623-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTAMANTE",
        "first_name": "STEVEN KALANI",
        "middle_name": "SINFUEGO",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-10",
        "last_updated": "2024-08-20",
        "certification_date": "2024-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A193132",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pomona, CA

Sources for this page

Verify at the official NPI Registry.