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NPI Code Detail

MEDICARE: BUHARI & DEGUZMAN, INC. A MED CORP

MEDICARE: BUHARI & DEGUZMAN, INC. A MED CORP
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
1204C00000XSports Medicine (Neuromusculoskeletal Medicine) PhysicianA82278CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11700855418OTHERCABUHARI INDIVIDUAL NPI
21730158460OTHERCADEGUZMAN INDIVIDUAL NPI

General Provider Information

NPI Number : 1760506513
Entity Type Code : Organization
Provider Name (Legal Business Name) : BUHARI & DEGUZMAN, INC. A MED CORP
Provider Business Mailing Address
First Line : 1805 N CALIFORNIA STREET
Second Line : SUITE 401
City : STOCKTON
State : CA
Zip : 95204-6033
Country : US
Telephone Number : 209-477-4421
Fax Number : 209-477-7211
Provider Business Practice Location Address
First Line : 1805 N CALIFORNIA STREET
Second Line : SUITE 401
City : STOCKTON
State : CA
Zip : 95204-6033
Country : US
Telephone Number : 209-477-4421
Fax Number : 209-477-7211
Authorized Official
Title or Position : MD
Name : DR. SHIRAZ BUHARI
Credential : MD
Telephone Number : 209-477-4421
Provider Enumeration Date : 03/19/2007
Last Update Date : 10/02/2009

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