Organization
DORIS PABLO-BUSTOS, MD PC
Active
Organization
DORIS PABLO-BUSTOS, MD PC
Active
Other names
Doris Pablo-Bustos, MD PC
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE YRASTORZA (RCM)
(202) 269-6430
Entity
Organization
Contact information
Practice address
1140 VARNUM ST NE PMB 202, WASHINGTON, DC 20017-2151
(202) 269-6430
(202) 269-6598
Mailing address
1140 VARNUM ST NE PMB 202, WASHINGTON, DC 20017-2151
(202) 269-6430
(202) 269-6598
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
302F00000X
Exclusive Provider Organization
—
—
302R00000X
Health Maintenance Organization
—
—
305R00000X
Preferred Provider Organization
—
—
305S00000X
Point of Service
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101056019
LICENSE
VA
05
—
033872900
—
DC
05
—
050883700
—
DC
01
—
09D0948025
CLIA
DC
05
—
3001576058000
—
VA
05
—
553223000
—
MD
01
—
D0058776
LICENSE
MD
01
—
F8110001
BCBS
DC
01
—
MD30307
LICENSE
DC
Enumeration date
12/05/2007
Last updated
09/02/2025
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