Individual
JEREMY BUSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
3838 SHERMAN DR STE 9, RIVERSIDE, CA 92503-4001
(951) 352-9228
(951) 352-9357
Mailing address
3838 SHERMAN DRIVE SUITE 9, RIVERSIDE, CA 92503
(951) 352-9228
(951) 352-9357
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E5180
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CA174235
MEDICARE PTAN
CA
Enumeration date
05/23/2012
Last updated
07/21/2022
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