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Organization
W RICHARD BUKATA MD INC.
Active
Organization
W RICHARD BUKATA MD INC.
Active
Other names
San Gabriel Emergency Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD BUKATA (PRESIDENT)
(626) 836-3700
Entity
Organization
Contact information
Practice address
438 W LAS TUNAS DR, SAN GABRIEL, CA 91776-1216
(626) 289-5454
Mailing address
FILE 57430, LOS ANGELES, CA 90074-7430
(800) 819-2424
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0082310
—
CA
01
—
ZZZ56564Z
BLUE SHIELD
—
Enumeration date
07/15/2006
Last updated
04/09/2008
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