MEDICARE: SCOTT DAVID BUIS P,A,-C

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	PA13789	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	PA13789	OTHER	CA	CALIFORNIA STATE LICENSE

General Provider Information

NPI Number	:	1972663938
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT DAVID BUIS P,A,-C

Provider Business Mailing Address
First Line	:	3941 SAN DIMAS ST
Second Line	:	SUITE 102
City	:	BAKERSFIELD
State	:	CA
Zip	:	93301-5734
Country	:	US
Telephone Number	:	661-324-6593
Fax Number	:

Provider Business Practice Location Address
First Line	:	2600 BLACKSTONE CT
Second Line	:	SUITE 102
City	:	BAKERSFIELD
State	:	CA
Zip	:	93304-5401
Country	:	US
Telephone Number	:	661-324-6593
Fax Number	:

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

Provider Enumeration Date	:	12/11/2006
Last Update Date	:	03/07/2023

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Directions to “ SCOTT DAVID BUIS P,A,-C” Practice Location

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