Provider Demographics
NPI:1881655918
Name:SHIFFMAN & BUCH MDS INC
Entity Type:Organization
Organization Name:SHIFFMAN & BUCH MDS INC
Other - Org Name:KENNETH L BUCH, M.D. AND MICHAEL I. SHIFFMAN, M.D. A MEDICAL CORP.
Other - Org Type:Other Name
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:L
Authorized Official - Last Name:BUCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-989-1917
Mailing Address - Street 1:15211 VANOWEN ST
Mailing Address - Street 2:SUITE 207
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-3606
Mailing Address - Country:US
Mailing Address - Phone:818-989-1917
Mailing Address - Fax:818-989-0751
Practice Address - Street 1:15211 VANOWEN ST
Practice Address - Street 2:SUITE 207
Practice Address - City:VAN NUYS
Practice Address - State:CA
Practice Address - Zip Code:91405-3606
Practice Address - Country:US
Practice Address - Phone:818-989-1917
Practice Address - Fax:818-989-0751
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-29
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAEN745A207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1497719512OtherINDIVIDUAL NPI (DR. SHIFFMAN)
CA1346200730OtherINDIVIDUAL NPI (DR. BUCH)
CA00G271420Medicaid
CAZZZ55247ZOtherBLUE SHIELD GROUP ID
CA1346200730OtherINDIVIDUAL NPI (DR. BUCH)
BUCHA49791Medicare UPIN
CAG27142Medicare ID - Type UnspecifiedGROUP ID