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Organization
RICHARD L BUCCIGROSS MD A MEDICAL CORPORATION
Active
Organization
RICHARD L BUCCIGROSS MD A MEDICAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD LESLIE BUCCIGROSS M.D. (PRESIDENT)
(858) 565-0900
Entity
Organization
Contact information
Practice address
4550 KEARNY VILLA RD, SUITE 214, SAN DIEGO, CA 92123-1578
(858) 565-0900
Mailing address
4550 KEARNY VILLA RD, SUITE 214, SAN DIEGO, CA 92123-1578
(858) 565-0900
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
G31185
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G311850
—
CA
Enumeration date
02/04/2009
Last updated
02/04/2009
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