Provider Demographics
NPI:1184137846
Name:ROBERT W BUECHEL DC CHIROPRACTIC CORP
Entity type:Organization
Organization Name:ROBERT W BUECHEL DC CHIROPRACTIC CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:WESLEY
Authorized Official - Last Name:BUECHEL
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:858-866-6688
Mailing Address - Street 1:4747 MISSION BLVD STE 6
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-2541
Mailing Address - Country:US
Mailing Address - Phone:858-866-6688
Mailing Address - Fax:858-362-7468
Practice Address - Street 1:4747 MISSION BLVD STE 6
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92109-2541
Practice Address - Country:US
Practice Address - Phone:858-866-6688
Practice Address - Fax:858-362-7468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26017111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Multi-Specialty