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General NPI Number Information
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NPI Number | 1467415174
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Entity Type | Individual
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Provider Name | HEIDI BYERS BUSCH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2006
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Last Update Date | 08/15/2024
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Provider Practice Location Address
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Address Line | 906 SYCAMORE AVE STE 100
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City | VISTA
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State | CA
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Zip | 92081-7851
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Country | US
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Telephone | 760-249-7007
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Fax | 858-550-0676
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Provider Business Mailing Address
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Address Line | 906 SYCAMORE AVE STE 100
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City | VISTA
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State | CA
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Zip | 92081-7851
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Country | US
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Telephone | 760-249-7007
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Fax | 858-550-0676
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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 | C51650
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License Number State | CA
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