Healthcare Provider Details

I. General information

NPI: 1891374278
Provider Name (Legal Business Name): THOMAS BUSCH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2021
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2660 GRANT RD STE E
MOUNTAIN VIEW CA
94040-4344
US

IV. Provider business mailing address

11530 UPLAND WAY
CUPERTINO CA
95014-5104
US

V. Phone/Fax

Practice location:
  • Phone: 408-871-3400
  • Fax:
Mailing address:
  • Phone: 408-893-9407
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA201067
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: