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Active NPI 1275144313 Individual Practitioner Female Practitioner

Sofia Carmen Bustillo

Physician Assistant - Medical • Seal Beach, CA

✓ Accepts Medicare Assignment

Professional Overview & Biography Verified Profile Summary

Sofia Bustillo is a certified Physician Assistant - Medical practicing in Seal Beach, CA. With approximately 6 years of clinical experience since completing medical education in 2020, Sofia Bustillo delivers high-quality medical care to the local community at 1709 CORAL PL.

Sofia Bustillo is affiliated with Providence Saint Johns Medical Foundation and accepts Medicare assignment.

Frequently performed procedures and clinical services include emergency department visit for life threatening or functioning severity, emergency department visit with moderate level of medical decision making, established patient outpatient office visit. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

1709 Coral Pl

Seal Beach, CA 907405712

Telephone 5625885143

Medicare Profile & Education

Medical School

Other

Graduation Year

2020

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

In-Person Only

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant - Medical in Seal Beach, CA

Experienced Practitioner (5-10 Yrs)
Practitioner Clinical Experience
6 Yrs Matches City Avg
City Avg: 6.0 Yrs
State Avg: 15.6 Yrs
Regional Practice Density
3 Specialists

Practicing in Seal Beach, CA (3472 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
86.5% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Bustillo (6 Years) 6 Yrs
Seal Beach Specialty Average (6.0 Years) 6.0 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)
Reporting Year:
HCPCS Code & Description Services Patients Submitted Charge Medicare Allowed
99285 Emergency department visit for life threatening or functioning severity
245 240 $1227.80 $149.63
99284 Emergency department visit with moderate level of medical decision making
160 155 $832.00 $103.33
99213 Established patient office or other outpatient visit, typically 15 minutes
18 18 $444.00 $83.85
99283 Emergency department visit with low level of medical decision making
12 11 $440.00 $60.90

Medical Specialties & State Licenses

CMS Verified: 2026-07-09
Physician Assistant - Medical Primary Specialty

NUCC Taxonomy Code: 363AM0700X

State License CA 58679

Definition to come...

Physician Assistant - Medical

NUCC Taxonomy Code: 363AM0700X

Definition to come...

Physician Assistant

NUCC Taxonomy Code: 363A00000X

State License CA PA58679

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Hospital & Practice Group Affiliations

Providence Saint Johns Medical Foundation

901 Wilshire Blvd, Santa Monica, CA 904011854

Providence Saint Johns Medical Foundation

2336 Santa Monica Blvd, Santa Monica, CA 904042938

Phone: 3108296789

Providence Saint Johns Medical Foundation

2121 Santa Monica Blvd, Santa Monica, CA 904042303

Phone: 3108295511

Secondary Practice Locations

901 Wilshire Blvd Fl 1

Santa Monica, CA 904011854

Phone: 3108298441

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2026

Physician Assistant (License #58679 in CA)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) December 17, 2024

Physician Assistant (License #58679 in CA)

NPI Profile Active August 12, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location August 12, 2020

Registered at 1709 CORAL PL, SEAL BEACH, CA 907405712 (Tel: 5625885143)

📍
Updated Business Mailing Address August 12, 2020

Registered at 1709 CORAL PL, SEAL BEACH, CA 907405712 (Tel: 5625885143)

👤
Provider Name / Credentials Updated August 12, 2020

Recorded as SOFIA BUSTILLO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 12, 2020

Physician Assistant

🟢
Initial NPI Registration & Enumeration August 12, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1275144313
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 12, 2020
Last Update: July 09, 2026
Sole Proprietor: Yes

Mailing Address

1709 Coral Pl

Seal Beach, CA 907405712

Phone: 5625885143

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.