Sofia Carmen Bustillo
Sofia Carmen Bustillo is a Physician Assistant in Seal Beach, California. Qualified in 2020, 6 years ago. Practices with Providence Saint Johns Medical Foundation, a 285-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California.
- Years since qualifying
- 6
- Licensed in
- CA
- In the registry since
- 2020
- Specialties on file
- 3
Practice location Address checks out
1709 Coral PlSeal Beach, CA 90740-5712
Phone: (562) 588-5143
Show map & directions
Directions in Google Maps · Apple Maps · OpenStreetMap
Pin is approximate — placed at the ZIP-code centre, not the exact door.
Additional practice locations (1)
- 901 Wilshire Blvd Fl 1, Santa Monica, CA 90401-1854 — (310) 829-8441
Specialties & licences
| Medical Physician Assistant (primary) | Taxonomy 363AM0700X · Licence 58679 (CA) |
|---|---|
| Medical Physician Assistant | Taxonomy 363AM0700X |
| Physician Assistant | Taxonomy 363A00000X · Licence PA58679 (CA) |
Record details
| NPI number | 1275144313 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Sole proprietor | Yes |
| NPI enumerated | August 12, 2020 |
| Last updated in NPPES | July 9, 2026 |
| Certification date | July 9, 2026 |
| Mailing address | 1709 Coral Pl, Seal Beach, CA 90740-5712 |
Medicare enrollment
| Medicare specialty | PHYSICIAN ASSISTANT |
|---|---|
| Medical school | OTHER |
| Graduated | 2020 (6 years in practice) |
| Group practice | Providence Saint Johns Medical Foundation — 285 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 3 on file with Medicare |
Other providers in Seal Beach
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James Joseph Constabileo, PHYSICIANASSISTANT
12501 Seal Beach Blvd Ste 220, Seal Beach, CA 90740-2755 · (562) 430-1666
-
Lauren N Swanson, PA-C
1198 Pacific Coast Hwy Ste I, Seal Beach, CA 90740-6251 · (562) 799-7071
-
Judy Yejin Yoo, PA
1198 Pacific Coast Hwy Ste 1, Seal Beach, CA 90740-6251 · (562) 799-7071