Individual
ANITA MELENDEZ BUSTILLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3401 MUSTANG WAY, HEMET, CA 92545-9257
(951) 743-0396
Mailing address
258 N THOMPSON ST, HEMET, CA 92543-4311
(951) 743-0396
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
MPSS-ZQJEDF
CA
Other
Enumeration date
04/26/2022
Last updated
02/23/2023
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