Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | G42457 | CA |
NPI | 1003864737 |
---|---|
Provider Name | Dennis J Buchanan |
First Address | Fullerton, CA 92835-3601 |
Second Address | Fullerton, CA 92835-3601 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2006 |
Last Update Date | 15/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A48973 | (02) |