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NPI Code Detail

MEDICARE: DR. JAVIER BUSTAMANTE M.D.

MEDICARE: DR. JAVIER BUSTAMANTE M.D.
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
1174400000XSpecialistA40966CA
2208000000XPediatrics PhysicianA40966CA

General Provider Information

NPI Number : 1881641595
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAVIER BUSTAMANTE M.D.
Provider Business Mailing Address
First Line : 300 OLD RIVER RD
Second Line : SUITE 105
City : BAKERSFIELD
State : CA
Zip : 93311-9503
Country : US
Telephone Number : 661-663-4700
Fax Number : 661-663-4740
Provider Business Practice Location Address
First Line : 300 OLD RIVER RD
Second Line : SUITE 105
City : BAKERSFIELD
State : CA
Zip : 93311-9503
Country : US
Telephone Number : 661-663-4700
Fax Number : 661-663-4740
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/28/2006
Last Update Date : 10/02/2015

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