Provider Demographics
NPI:1508935214
Name:BUCHHOLZ, STEVEN R (DPM)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:R
Last Name:BUCHHOLZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 W LA PALMA
Mailing Address - Street 2:#100
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801
Mailing Address - Country:US
Mailing Address - Phone:714-774-1550
Mailing Address - Fax:714-774-0616
Practice Address - Street 1:1011 W LA PALMA
Practice Address - Street 2:#100
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801
Practice Address - Country:US
Practice Address - Phone:714-774-1550
Practice Address - Fax:714-774-0616
Is Sole Proprietor?:No
Enumeration Date:2006-11-07
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE2822213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T11483Medicare UPIN
E2822Medicare ID - Type Unspecified