Individual
NICHOLAS BUSTAMANTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1360 E SPRUCE AVE STE 102, FRESNO, CA 93720-3378
(559) 440-9200
(559) 440-9222
Mailing address
1360 E SPRUCE AVE STE 102, FRESNO, CA 93720-3378
(559) 440-9200
(559) 440-9222
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
54759
CA
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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