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General NPI Number Information
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NPI Number | 1063811453
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Entity Type | Organization
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Legal Business Name | IRA H. BUCHALTER, M.D.
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 08/21/2014
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Provider Practice Location Address
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Address Line | 28548 MOUNTAIN MEADOW RD
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City | ESCONDIDO
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State | CA
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Zip | 92026-6909
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Country | US
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Telephone | 541-499-2425
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Fax |
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Provider Business Mailing Address
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Address Line | 28548 MOUNTAIN MEADOW RD
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City | ESCONDIDO
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State | CA
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Zip | 92026-6909
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Country | US
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Telephone | 541-499-2425
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. IRA H. BUCHALTER
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Credential | M.D.
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Telephone | 541-499-2425
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | G21971
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License Number State | CA
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