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General NPI Number Information
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NPI Number | 1760506513
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Entity Type | Organization
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Legal Business Name | BUHARI & DEGUZMAN, INC. A MED CORP
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Dates
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Enumeration Date | 03/19/2007
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Last Update Date | 10/02/2009
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Provider Practice Location Address
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Address Line | 1805 N CALIFORNIA STREET SUITE 401
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City | STOCKTON
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State | CA
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Zip | 95204-6033
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Country | US
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Telephone | 209-477-4421
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Fax | 209-477-7211
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Provider Business Mailing Address
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Address Line | 1805 N CALIFORNIA STREET SUITE 401
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City | STOCKTON
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State | CA
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Zip | 95204-6033
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Country | US
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Telephone | 209-477-4421
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Fax | 209-477-7211
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Authorized Official
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Title or Position | MD
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Name | DR. SHIRAZ BUHARI
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Credential | MD
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Telephone | 209-477-4421
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 204C00000X
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Taxonomy Name | Sports Medicine (Neuromusculoskeletal Medicine) Physician
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License Number | A82278
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License Number State | CA
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