Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | A68463 | CA |
N | 207VG0400X | Gynecologist | A68463 | CA |
N | 207VX0000X | Obstetrician | A68463 | CA |
NPI | 1376663831 |
---|---|
Provider Name | Charlene Ann Buechner |
First Address | San Diego, CA 92102-4541 |
Second Address | San Diego, CA 92113-2113 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 17/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00A684630 | (05) | CA |
H04801 | (02) | CA |
ZZZ57305Z | BLUE SHIELD OF CA (01) | CA |