Provider Demographics
NPI:1619958147
Name:BUELER, JOHN JR (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:BUELER
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 989
Mailing Address - Street 2:
Mailing Address - City:CRESTLINE
Mailing Address - State:CA
Mailing Address - Zip Code:92325-0989
Mailing Address - Country:US
Mailing Address - Phone:909-338-6477
Mailing Address - Fax:909-338-1639
Practice Address - Street 1:580 FOREST SHADE
Practice Address - Street 2:#4
Practice Address - City:CRESTLINE
Practice Address - State:CA
Practice Address - Zip Code:92325-0989
Practice Address - Country:US
Practice Address - Phone:909-338-6477
Practice Address - Fax:909-338-1639
Is Sole Proprietor?:No
Enumeration Date:2005-11-10
Last Update Date:2015-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17037111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC0170370Medicare ID - Type Unspecified