MEDICARE: ANTHONY P BUEN PHYSICAL THERAPIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	10626	FL

General Provider Information

NPI Number	:	1437250628
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANTHONY P BUEN PHYSICAL THERAPIST

Provider Business Mailing Address
First Line	:	4129 ALMOND JOY CT
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89115-4108
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	11301 WILSHIRE BLVD
Second Line	:	BLDG 500 RM 1454
City	:	LOS ANGELES
State	:	CA
Zip	:	90073-1003
Country	:	US
Telephone Number	:	310-268-3329
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2006
Last Update Date	:	07/08/2007

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