Individual
MARK BUSTOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
(505) 338-3320
(505) 338-3319
Mailing address
2551 COORS BLVD NW, ALBUQUERQUE, NM 87120-1213
(505) 338-3320
(505) 338-3319
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
R33382
NM
Other
Enumeration date
08/11/2009
Last updated
08/20/2009
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