Provider Demographics
NPI:1639143530
Name:BUHAY, CARINA D (MD)
Entity Type:Individual
Prefix:
First Name:CARINA
Middle Name:D
Last Name:BUHAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CARINA
Other - Middle Name:DELEON
Other - Last Name:BUHAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 12209
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92423-2209
Mailing Address - Country:US
Mailing Address - Phone:909-335-4188
Mailing Address - Fax:909-478-3644
Practice Address - Street 1:2150 N WATERMAN AVE
Practice Address - Street 2:STE 200
Practice Address - City:SAN BERNARDINO
Practice Address - State:CA
Practice Address - Zip Code:92404-4811
Practice Address - Country:US
Practice Address - Phone:909-881-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA490630207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A490630Medicaid
CA00A490630Medicaid