Individual
KRISTINE BUSTOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
1200 N PACIFIC AVE STE 104, GLENDALE, CA 91202
(818) 956-9913
Mailing address
1200 N PACIFIC AVE STE 104, GLENDALE, CA 91202-3804
(818) 956-9913
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95008705
CA
363LP2300X
Primary Care Nurse Practitioner
Primary
819234
CA
Other
Enumeration date
03/21/2018
Last updated
08/22/2018
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