Individual
ANDRES BUSTAMANTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
227 CHURCH AVE, CHULA VISTA, CA 91910-2702
(619) 426-9610
(619) 426-8737
Mailing address
227 CHURCH AVE, CHULA VISTA, CA 91910-2702
(619) 426-9610
(619) 426-8737
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A70351
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A703510
—
CA
Enumeration date
08/31/2006
Last updated
12/01/2021
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