Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Kevin Mitsutoshi Gustafson, MD

Individual provider Ophthalmology Physician · NPI 1093210981

Dr. Kevin Mitsutoshi Gustafson, MD is an Ophthalmology in Santa Ana, California. Graduated from University of California, Irvine, California College of Medicine in 2018, 8 years ago. Practices with Southern California Permanente Medical Group, an 11,242-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
8
Trained at
University of California, Irvine, California College of Medicine
Licensed in
CA
In the registry since
2018
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

3401 S Harbor Blvd
Santa Ana, CA 92704-7933
Phone: (888) 988-2800
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence A165714 (CA)

Record details

NPI number1093210981
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 24, 2018
Last updated in NPPESOctober 27, 2023
Certification dateAugust 24, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPHTHALMOLOGY
Medical schoolUNIVERSITY OF CALIFORNIA, IRVINE, CALIFORNIA COLLEGE OF MEDICINE
Graduated 2018 (8 years in practice)
Group practice Southern California Permanente Medical Group — 11242 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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