Provider Demographics
NPI:1326076043
Name:BUXTON, MICHELLE F (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:F
Last Name:BUXTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:F
Other - Last Name:KUYKENDALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:10790 RANCHO BERNARDO RD
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92127-5705
Mailing Address - Country:US
Mailing Address - Phone:760-901-5010
Mailing Address - Fax:
Practice Address - Street 1:4318 MISSION AVE
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92057-6541
Practice Address - Country:US
Practice Address - Phone:760-901-5010
Practice Address - Fax:760-433-1263
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA17264363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical