Organization
JERROLD C BUSTOS MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERROLD C BUSTOS MD (PRESIDENT)
(949) 588-2190
Entity
Organization
Contact information
Practice address
5700 SAN FERNANDO RD, GLENDALE, CA 91202-2104
(818) 637-7766
(818) 956-1706
Mailing address
5 HOLLAND STE 101, IRVINE, CA 92618-2568
(949) 588-2190
(949) 588-2199
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A85842
CA
Other
Enumeration date
04/20/2011
Last updated
04/20/2011
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