Healthcare Provider Details

I. General information

NPI: 1497131718
Provider Name (Legal Business Name): CINDY BUFFALO RRT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2015
Last Update Date: 08/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7260 SEA CLIFF VILLAS UNIT 72
ST THOMAS VI
00802-2723
US

IV. Provider business mailing address

7260 SEA CLIFF VILLAS UNIT 72
ST THOMAS VI
00802-2723
US

V. Phone/Fax

Practice location:
  • Phone: 951-355-5275
  • Fax:
Mailing address:
  • Phone: 951-355-5275
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2279G1100X
TaxonomyGeneral Care Registered Respiratory Therapist
License Number23456
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: