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General NPI Number Information
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NPI Number | 1093397747
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Entity Type | Organization
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Legal Business Name | MADISON BUCHANAN MD
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Dates
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Enumeration Date | 04/22/2021
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Last Update Date | 02/10/2023
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Provider Practice Location Address
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Address Line | 240 TAMAL VISTA BLVD STE 160
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City | CORTE MADERA
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State | CA
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Zip | 94925-1156
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Country | US
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Telephone | 415-494-9165
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Fax |
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Provider Business Mailing Address
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Address Line | 45 SAN CLEMENTE DR STE A200
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City | CORTE MADERA
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State | CA
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Zip | 94925-1204
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Country | US
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Telephone | 415-494-9165
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Fax |
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Authorized Official
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Title or Position | MD
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Name | DR. MADISON MICHELE BUCHANAN
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Credential | MD
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Telephone | 415-494-9165
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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