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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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