Provider Demographics
NPI:1376648170
Name:BUCHSBAUM, EDWARD GEORGE (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:GEORGE
Last Name:BUCHSBAUM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20911 EARL STREET
Mailing Address - Street 2:SUITE 301
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-371-1388
Mailing Address - Fax:310-371-3439
Practice Address - Street 1:20911 EARL STREET
Practice Address - Street 2:SUITE 301
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-371-1388
Practice Address - Fax:310-371-3439
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2011-12-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG36432207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G364320Medicaid
A91782Medicare UPIN
CA00G364320Medicaid