Individual
COREY JAMES BUCKLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2575 YORBA LINDA BLVD, FULLERTON, CA 92831-1615
(760) 399-6894
Mailing address
706 1/2 KNOXVILLE AVE, HUNTINGTON BEACH, CA 92648-4114
(760) 822-9844
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1226193
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
07/10/2023
Last updated
01/02/2025
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