Healthcare Provider Details

I. General information

NPI: 1033382346
Provider Name (Legal Business Name): ELIZABETH ANNE BUESCHER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2008
Last Update Date: 03/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

455 O'CONNOR DRIVE SUITE 370
SAN JOSE CA
95128-1600
US

IV. Provider business mailing address

400 RACE ST
SAN JOSE CA
95126-3518
US

V. Phone/Fax

Practice location:
  • Phone: 408-831-5720
  • Fax: 408-831-5781
Mailing address:
  • Phone: 408-278-3000
  • Fax: 650-327-2794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberA115930
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: