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Organization
ROMAN P. BUKACHEVSKY, MD, INC
Active
Organization
ROMAN P. BUKACHEVSKY, MD, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROMAN P BUKACHEVSKY M.D. (INCORPORATOR)
(805) 434-5960
Entity
Organization
Contact information
Practice address
295 POSADA LN, SUITE B, TEMPLETON, CA 93465-4055
(805) 434-5960
(805) 434-5963
Mailing address
295 POSADA LN, SUITE B, TEMPLETON, CA 93465-4055
(805) 434-5960
(805) 434-5963
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G71259
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G712591
—
CA
Enumeration date
02/27/2007
Last updated
09/04/2007
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