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General NPI Number Information
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NPI Number | 1093755027
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Entity Type | Individual
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Provider Name | DAVID VANBUREN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 07/27/2015
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Provider Practice Location Address
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Address Line | 6145 N THESTA ST
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City | FRESNO
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State | CA
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Zip | 93710-5266
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Country | US
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Telephone | 559-446-1065
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Fax | 559-436-8193
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Provider Business Mailing Address
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Address Line | 6145 N THESTA ST
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City | FRESNO
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State | CA
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Zip | 93710-5266
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Country | US
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Telephone | 559-446-1065
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Fax | 559-436-8193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | G5725
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 204F00000X
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Taxonomy Name | Transplant Surgery Physician
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License Number | C54839
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | G5725
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | C54839
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License Number State | CA
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Taxonomy #5
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | C54839
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License Number State | CA
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