# JC BULLER MD & AM CLARKE MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558543272
- **Authorized official:** DR. JUANCARLOS BULLER M.D. (PRESIDENT)
- **Authorized official phone:** (707) 253-1393

## Contact information

- **Practice address:** 1100 TRANCAS ST, SUITE 240, NAPA, CA 94558-2908
- **Practice address phone:** (707) 253-1393
- **Practice address fax:** (707) 253-9178
- **Mailing address:** 1100 TRANCAS ST, SUITE 240, NAPA, CA 94558-2908
- **Mailing address phone:** (707) 253-1393
- **Mailing address fax:** (707) 253-9178

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | A066601 | CA | Yes |
| 207Q00000X | Family Medicine Physician | A66060 | CA | — |
| 207QS0010X | Sports Medicine (Family Medicine) Physician | A066601 | CA | — |

## Other

- **Enumeration date:** 12/05/2007
- **Last updated:** 12/05/2007