Individual
DR. KEVIN DONALD BUCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3020 CHILDRENS WAY, SAN DIEGO, CA 92123-4223
(858) 966-8800
Mailing address
3020 CHILDRENS WAY # MC5003, SAN DIEGO, CA 92123-4223
(858) 309-6300
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
G87482
CA
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
G87482
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G874820
—
CA
01
—
00G874820851
CAL OPTIMA
CA
Enumeration date
09/12/2006
Last updated
08/14/2025
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