Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | C42204 | CA |
Y | 111NI0900X | Internist | C42204 | CA |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | C42204 | CA |
NPI | 1003143991 |
---|---|
Provider Name | Dr. Thomas Allen Buchanan |
First Address | Los Angeles, CA 90033-5313 |
Second Address | Los Angeles, CA 90033-5313 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2009 |
Last Update Date | 12/11/2009 |