Sunny James Bautista Bustos

Primary specialty

Geriatric Physical TherapistTaxonomy code 2251G0304X

License

28941 Issued in CA

Practice address

13049 Misty Meadow CT
Moreno Valley, CA 92555-4535

Phone

(951) 452-6691

NPI assigned

Aug 19, 2022

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1660867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660867200000",
    "number": "1730807355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13049 MISTY MEADOW CT",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554535",
            "telephone_number": "951-452-6691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13049 MISTY MEADOW CT",
            "city": "MORENO VALLEY",
            "state": "CA",
            "postal_code": "925554535",
            "telephone_number": "951-452-6691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSTOS",
        "first_name": "SUNNY JAMES",
        "middle_name": "BAUTISTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-08-19",
        "last_updated": "2022-08-19",
        "certification_date": "2022-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "CA",
            "license": "28941",
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "CA",
            "license": "28941",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patrick Curtis Burrell, N.D.
• Tristen Burt, DO
• Brian K Bush, RN,BSN
• Paige Matthew Alexis Bush, MSOT, OTR/L
• Barbara Jane Bussey, MFT
• Candace Quatina Butler
• Larry D Butler Sr.
• Precious Ann Butler, RN, LVN
• C & M Comfort Home LLC (C & M Comfort Home)
• C.L.S.Non-Emergency Medical Transportation Services

• Geriatric Physical Therapist in Moreno Valley, CA
• Providers in Moreno Valley, CA by specialty
• Geriatric Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2022; 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.