1184137846 NPI number — ROBERT W BUECHEL DC CHIROPRACTIC CORP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184137846 NPI number — ROBERT W BUECHEL DC CHIROPRACTIC CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ROBERT W BUECHEL DC CHIROPRACTIC CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1184137846
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4747 MISSION BLVD STE 6
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN DIEGO
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
92109-2541
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
858-866-6688
Provider Business Mailing Address Fax Number:
858-362-7468

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4747 MISSION BLVD STE 6
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN DIEGO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
92109-2541
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
858-866-6688
Provider Business Practice Location Address Fax Number:
858-362-7468
Provider Enumeration Date:
11/15/2017

Additional Information

Authorized Official

Authorized Official Last Name:
BUECHEL
Authorized Official First Name:
ROBERT
Authorized Official Middle Name:
WESLEY
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
858-866-6688

Provider Taxonomy Codes

  • Taxonomy code: 111NS0005X , with the licence number:  DC26017 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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