=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598952244
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CINDY S. BUCHANAN P.A.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/26/2007
-----------------------------------------------------
Last Update Date | 03/17/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1220 LAS TABLAS RD STE 1418
-----------------------------------------------------
City | TEMPLETON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93465-9756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-434-4315
-----------------------------------------------------
Fax | 805-434-4314
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1220 LAS TABLAS RD STE 1418
-----------------------------------------------------
City | TEMPLETON
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 93465-9756
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 805-434-4315
-----------------------------------------------------
Fax | 805-434-4314
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363A00000X
-----------------------------------------------------
Taxonomy Name | Physician Assistant
-----------------------------------------------------
License Number | 19023
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------