Provider Demographics
NPI:1053439083
Name:BUCHANAN, SONYA W (MD)
Entity type:Individual
Prefix:
First Name:SONYA
Middle Name:W
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:15751 ROCKFIELD BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92618-2832
Mailing Address - Country:US
Mailing Address - Phone:949-206-9100
Mailing Address - Fax:949-206-1862
Practice Address - Street 1:15751 ROCKFIELD BLVD
Practice Address - Street 2:STE 100
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92618-2832
Practice Address - Country:US
Practice Address - Phone:949-206-9100
Practice Address - Fax:949-206-1862
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2016-04-05
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NC0099015092083X0100X
CAC1364052083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2347843Medicare PIN
NC2075360Medicare UPIN