Provider Demographics
NPI:1831382829
Name:BUENO AND SONS INC.
Entity type:Organization
Organization Name:BUENO AND SONS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BUENO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-531-7591
Mailing Address - Street 1:924 BUENA VISTA ST STE 102
Mailing Address - Street 2:
Mailing Address - City:DUARTE
Mailing Address - State:CA
Mailing Address - Zip Code:91010-1779
Mailing Address - Country:US
Mailing Address - Phone:626-531-7591
Mailing Address - Fax:626-531-7596
Practice Address - Street 1:924 BUENA VISTA ST STE 102
Practice Address - Street 2:
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-1779
Practice Address - Country:US
Practice Address - Phone:626-531-7591
Practice Address - Fax:626-531-7596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-22
Last Update Date:2020-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA050000589251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA058301Medicare PIN