Individual
DR. JUANCARLOS BULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
300 HARTLE CT, NAPA, CA 94559-4078
(707) 254-1775
(707) 254-1779
Mailing address
1141 PEAR TREE LN STE 100, NAPA, CA 94558-6485
(707) 254-1770
(707) 254-1779
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A66601
CA
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
A66601
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A666010
BLUE SHIELD PIN
CA
Enumeration date
03/17/2006
Last updated
09/01/2021
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