Healthcare Provider Details

I. General information

NPI: 1861338667
Provider Name (Legal Business Name): JASON BUCHANAN BUCHANAN EMTP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/25/2026
Last Update Date: 04/25/2026
Certification Date: 04/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34011 AMBER LANTERN ST APT B
DANA POINT CA
92629-5575
US

IV. Provider business mailing address

34011 AMBER LANTERN ST APT B
DANA POINT CA
92629-5575
US

V. Phone/Fax

Practice location:
  • Phone: 951-760-6513
  • Fax:
Mailing address:
  • Phone: 951-760-6513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP17304
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: