MEDICARE: DR. THOMAS ALLEN BUCHANAN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	C42204	CA
2	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	C42204	CA

General Provider Information

NPI Number	:	1003143991
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS ALLEN BUCHANAN M.D.

Provider Business Mailing Address
First Line	:	1500 SAN PABLO ST
Second Line	:	3 NORTH UNIVERSITY HOSPITAL
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-5313
Country	:	US
Telephone Number	:	323-442-9576
Fax Number	:

Provider Business Practice Location Address
First Line	:	1500 SAN PABLO ST
Second Line	:	3 NORTH UNIVERSITY HOSPITAL
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-5313
Country	:	US
Telephone Number	:	323-442-9576
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/12/2009
Last Update Date	:	11/12/2009

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