=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679088090
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CLAUDETTE L BUEHLER DRT
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/07/2017
-----------------------------------------------------
Last Update Date | 12/07/2017
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7916 PEBBLE BEACH DR STE 206
-----------------------------------------------------
City | CITRUS HEIGHTS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95610-7790
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-961-1032
-----------------------------------------------------
Fax | 916-962-9830
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 7916 PEBBLE BEACH DR STE 206
-----------------------------------------------------
City | CITRUS HEIGHTS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95610-7790
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-961-1032
-----------------------------------------------------
Fax | 916-962-9830
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 247200000X
-----------------------------------------------------
Taxonomy Name | Other Technician
-----------------------------------------------------
License Number | RHP00041025
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------