Provider Demographics
NPI:1558446476
Name:BUCHBINDER, MICHAEL C (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:C
Last Name:BUCHBINDER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11546 DOWNEY AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-4955
Mailing Address - Country:US
Mailing Address - Phone:562-862-2020
Mailing Address - Fax:562-862-8721
Practice Address - Street 1:11546 DOWNEY AVE
Practice Address - Street 2:
Practice Address - City:DOWNEY
Practice Address - State:CA
Practice Address - Zip Code:90241-4955
Practice Address - Country:US
Practice Address - Phone:562-862-2020
Practice Address - Fax:562-862-8721
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG47834174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G478340Medicaid
CAA92770Medicare UPIN
CAG47834AMedicare ID - Type Unspecified