Individual
MR. ADAIR RUTHERFORD BUCKNER I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
775 W HEATHER ST, RIALTO, CA 92376-2677
(909) 875-4286
Mailing address
775 W HEATHER ST, RIALTO, CA 92376-2677
(909) 875-4286
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1181
CA
Other
Enumeration date
08/05/2007
Last updated
08/05/2007
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