Individual
BRUCE ALDER BUCKINGHAM
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
751 S BASCOM AVE, PEDIATRICS DEPARTMENT, SAN JOSE, CA 95128-2604
(408) 885-5630
Mailing address
761 MATADERO AVE, PALO ALTO, CA 94306-2736
(408) 218-6584
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
G25563
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G255630
—
CA
Enumeration date
05/31/2006
Last updated
07/08/2007
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