MEDICARE: BUSTAMANTE GARCIA MEDICAL CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1710830591
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BUSTAMANTE GARCIA MEDICAL CORP

Provider Business Mailing Address
First Line	:	4195 N VIKING WAY STE G
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-1470
Country	:	US
Telephone Number	:	562-231-7352
Fax Number	:	562-488-9686

Provider Business Practice Location Address
First Line	:	4195 N VIKING WAY STE G
Second Line	:
City	:	LONG BEACH
State	:	CA
Zip	:	90808-1470
Country	:	US
Telephone Number	:	562-231-7352
Fax Number	:	562-488-9686

Authorized Official
Title or Position	:	CEO
Name	:	CHRISTOPHER BUSTAMANTE
Credential	:	MD
Telephone Number	:	717-202-9808

Provider Enumeration Date	:	02/19/2026
Last Update Date	:	02/19/2026

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Directions to “BUSTAMANTE GARCIA MEDICAL CORP ” Practice Location

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