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General NPI Number Information
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NPI Number | 1679581268
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Entity Type | Individual
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Provider Name | CYRUS BUHARI DO
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Gender | Male
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Dates
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Enumeration Date | 08/03/2006
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Last Update Date | 01/22/2014
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Provider Practice Location Address
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Address Line | 2333 N CALIFORNIA ST
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City | STOCKTON
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State | CA
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Zip | 95204-5530
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Country | US
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Telephone | 209-464-2806
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Fax | 209-464-1647
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Provider Business Mailing Address
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Address Line | 2800 N CALIFORNIA ST SUITE 14A
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City | STOCKTON
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State | CA
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Zip | 95204-3757
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Country | US
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Telephone | 209-942-1005
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Fax | 209-942-0455
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 20A1923
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 20A1923
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | 20A9123
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License Number State | CA
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