Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | C41851 | CA |
N | 2080P0204X | Pediatric Emergency Doctor | C41851 | CA |
NPI | 1215930219 |
---|---|
Provider Name | Gregory Scott Buchert |
First Address | Orange, CA 92868-4231 |
Second Address | Orange, CA 92868-4231 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2005 |
Last Update Date | 08/07/2007 |