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General NPI Number Information
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NPI Number | 1942059266
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Entity Type | Individual
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Provider Name | MEREDITH JOAN BUESCHER PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/17/2024
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Last Update Date | 05/17/2024
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Provider Practice Location Address
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Address Line | 1700 E CESAR CHAVEZ AVE SUITE 2500
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City | LOS ANGELES
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State | CA
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Zip | 90033
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Country | US
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Telephone | 323-306-9632
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Fax |
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Provider Business Mailing Address
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Address Line | 5426 CORONADA DR
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City | MENTOR ON THE LAKE
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State | OH
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Zip | 44060-1406
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Country | US
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Telephone | 440-975-6423
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 64099
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License Number State | CA
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