| Doctor Name: | MR. ANGEL R BUSTAMANTE |
| NPI Number: | 1013127877 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA 16691 |
| Business Practice Address: | 941 S Atlantic Blvd Suite 101 Monterey Park, CA - 917544722 |
| Business Phone Number: | 6264588401 |
| Business Fax Number: | |
| Mailing Address: | 6534 Branch Ct, CORONA |
| State: | CA |
| Postal Code: | 928800803 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA 16691 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |