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NPI Code Detail

MEDICARE: DR. JULIO F BUENAVENTURA MD

MEDICARE:  DR. JULIO F BUENAVENTURA  MD
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
1207R00000XInternal Medicine PhysicianMD00009747WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2110056335OTHERRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1224270001OTHERWAGROUP HEALTH
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1477553246
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JULIO F BUENAVENTURA MD
Provider Business Mailing Address
First Line : 7501 92ND AVENUE CT SW
Second Line :
City : LAKEWOOD
State : WA
Zip : 98498-3973
Country : US
Telephone Number : 253-588-0058
Fax Number : 253-589-4862
Provider Business Practice Location Address
First Line : 7501 92ND AVENUE CT SW
Second Line :
City : LAKEWOOD
State : WA
Zip : 98498-3973
Country : US
Telephone Number : 253-588-0058
Fax Number : 253-589-4862
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/22/2005
Last Update Date : 05/17/2010

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Directions to “ DR. JULIO F BUENAVENTURA MD” Practice Location

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