Provider Demographics
NPI:1164559480
Name:BUCH, DHAVAL P (PT)
Entity Type:Individual
Prefix:MR
First Name:DHAVAL
Middle Name:P
Last Name:BUCH
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 CALLOWAY DR
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93312-6337
Mailing Address - Country:US
Mailing Address - Phone:661-588-4286
Mailing Address - Fax:661-588-9986
Practice Address - Street 1:1002 CALLOWAY DR
Practice Address - Street 2:
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93312-6337
Practice Address - Country:US
Practice Address - Phone:661-588-4286
Practice Address - Fax:661-588-9986
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT16581225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT0165810Medicaid
CA0PT165810Medicare PIN