Healthcare Provider Details

I. General information

NPI: 1497821987
Provider Name (Legal Business Name): BUSS CHIROPRACTIC INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/27/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55887 YUCCA TRL
YUCCA VALLEY CA
92284-2546
US

IV. Provider business mailing address

55887 YUCCA TRL
YUCCA VALLEY CA
92284-2546
US

V. Phone/Fax

Practice location:
  • Phone: 760-365-0804
  • Fax: 760-365-0706
Mailing address:
  • Phone: 760-365-0804
  • Fax: 760-365-0706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License NumberDC30051
License Number StateCA

VIII. Authorized Official

Name: DR. CHAD BUSS
Title or Position: PRESIDENT
Credential: D.C.
Phone: 760-365-0804