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General NPI Number Information
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NPI Number | 1134784168
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Entity Type | Individual
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Provider Name | MARIA GNARRA BUETHE MD, PHD
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Gender | Female
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Dates
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Enumeration Date | 05/06/2019
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Last Update Date | 06/21/2025
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Provider Practice Location Address
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Address Line | 1201 W LA VETA AVE
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City | ORANGE
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State | CA
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Zip | 92868-4203
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Country | US
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Telephone | 714-509-7987
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Fax | 949-898-6012
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Provider Business Mailing Address
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Address Line | 200 S MANCHESTER AVE STE 300
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City | ORANGE
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State | CA
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Zip | 92868-3219
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Country | US
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Telephone | 714-456-8888
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Fax |
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 187371
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207NP0225X
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Taxonomy Name | Pediatric Dermatology Physician
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License Number | 187371
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License Number State | CA
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