Healthcare Provider Details

I. General information

NPI: 1225526130
Provider Name (Legal Business Name): SAMANTHA ADRIANO BUHAY PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2018
Last Update Date: 04/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 H ST
CHULA VISTA CA
91910-4307
US

IV. Provider business mailing address

6780 FRIARS RD UNIT 261
SAN DIEGO CA
92108-1164
US

V. Phone/Fax

Practice location:
  • Phone: 619-691-7000
  • Fax:
Mailing address:
  • Phone: 575-740-5895
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number3978
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number41970
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: