Provider Demographics
NPI:1972704906
Name:BUCHMAN, BRAD P (MD)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:P
Last Name:BUCHMAN
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:9500 GILMAN DRIVE
Mailing Address - Street 2:MAIL CODE 0039
Mailing Address - City:LA JOLLA
Mailing Address - State:CA
Mailing Address - Zip Code:92093-0039
Mailing Address - Country:US
Mailing Address - Phone:858-534-2669
Mailing Address - Fax:858-534-7545
Practice Address - Street 1:9500 GILMAN DRIVE
Practice Address - Street 2:MAIL CODE 0039
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-0039
Practice Address - Country:US
Practice Address - Phone:858-534-2669
Practice Address - Fax:858-534-7545
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAG69458207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
F35194Medicare UPIN