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General NPI Number Information
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NPI Number | 1174439350
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Entity Type | Individual
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Provider Name | JEREMIE R BUCKLEY RN
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Gender | Male
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Dates
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Enumeration Date | 08/19/2026
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Last Update Date | 08/19/2026
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Provider Practice Location Address
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Address Line | 8160 DAY CREEK BLVD
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City | RANCHO CUCAMONGA
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State | CA
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Zip | 91739-8549
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Country | US
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Telephone | 909-825-7084
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Fax | 909-422-3006
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Provider Business Mailing Address
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Address Line | 37434 GLENOAKS RD
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City | TEMECULA
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State | CA
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Zip | 92592-8138
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Country | US
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Telephone | 951-466-7734
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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 | 2083P0901X
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Taxonomy Name | Public Health & General Preventive Medicine Physician
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License Number | 95237773
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License Number State | CA
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