Provider Demographics
NPI:1831222918
Name:BUCHANAN, BESS I (PHYSICIAN ASSISTANT)
Entity type:Individual
Prefix:MS
First Name:BESS
Middle Name:I
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 37
Mailing Address - Street 2:TR 567
Mailing Address - City:A.P.O. A.P.
Mailing Address - State:CA
Mailing Address - Zip Code:96555
Mailing Address - Country:US
Mailing Address - Phone:805-355-2224
Mailing Address - Fax:805-355-2026
Practice Address - Street 1:KWAJALEIN HOSPITAL
Practice Address - Street 2:OCEAN ROAD
Practice Address - City:A.P.O. A.P.
Practice Address - State:CA
Practice Address - Zip Code:96555
Practice Address - Country:US
Practice Address - Phone:805-355-2224
Practice Address - Fax:805-355-2026
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA146228363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA146228OtherPA-C LICENSURE