Provider Demographics
NPI:1790538049
Name:BUCH, OLIVIA MARY
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MARY
Last Name:BUCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CHILD ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94133-3010
Mailing Address - Country:US
Mailing Address - Phone:805-727-1311
Mailing Address - Fax:
Practice Address - Street 1:19 CHILD ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94133-3010
Practice Address - Country:US
Practice Address - Phone:805-727-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program