MEDICARE: JAMES BUFFA PHYSICIAN ASSISTANT

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	363A00000X	Physician Assistant	5601006763	MI

General Provider Information

NPI Number	:	1184052581
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES BUFFA PHYSICIAN ASSISTANT

Provider Business Mailing Address
First Line	:	1828 E BENNINGTON RD
Second Line	:
City	:	OWOSSO
State	:	MI
Zip	:	48867-8739
Country	:	US
Telephone Number	:	989-413-3805
Fax Number	:

Provider Business Practice Location Address
First Line	:	1241 E DYER RD
Second Line	:	SUITE 145
City	:	SANTA ANA
State	:	CA
Zip	:	92705-5611
Country	:	US
Telephone Number	:	949-289-9754
Fax Number	:

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

Provider Enumeration Date	:	10/22/2013
Last Update Date	:	10/22/2013

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