Bustamante, Rudolph

Bustamante, Rudolph is an individual health care provider with primary practice located at 1856 E Florence Blvd , Casa Grande AZ 85122-5303. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Bustamante, Rudolph can be contacted via phone (520) 381-0380.

Contact Information

Primary practice address
1856 E Florence Blvd Casa Grande AZ 85122-5303
Phone: (520) 381-0380
Fax: (520) 836-1826
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 6500 Arizona

Profile Details

NPI number 1124088968
LBN Legal business name Bustamante, Rudolph
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated Oct 14th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124088968 NPPES
Other Z137312 MEDICARE
MEDICAID 510984 MEDICARE
Other 03-1881 MEDICARE
Other 03-31815 MEDICARE
Other ZFQ31815 MEDICARE

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