MEDICARE: ROBERT L BUCKINGHAM M D INC

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	207RC0000X	Cardiovascular Disease Physician	G39064	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1669479184
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ROBERT L BUCKINGHAM M D INC

Provider Business Mailing Address
First Line	:	115 PIRIE RD
Second Line	:	#D
City	:	OJAI
State	:	CA
Zip	:	93023-3100
Country	:	US
Telephone Number	:	805-646-0104
Fax Number	:	805-646-9476

Provider Business Practice Location Address
First Line	:	115 PIRIE RD
Second Line	:	#D
City	:	OJAI
State	:	CA
Zip	:	93023-3100
Country	:	US
Telephone Number	:	805-646-0104
Fax Number	:	805-646-9476

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ROBERT L BUCKINGHAM
Credential	:	M D
Telephone Number	:	805-646-0104

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/10/2020

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