Buphant Society

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

IMF 85548 Issued in CA

Legal business name

BUPHANT SOCIETY

Practice address

1045 N. Eldorado
11
Stockton, CA 95202

Phone

(209) 670-6799

NPI assigned

Aug 31, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. David Grayson

Title

Ceo

Phone

(209) 670-6799

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1440979200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440979200000",
    "number": "1255708855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1045 N. ELDORADO #11",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1045 N. ELDORADO",
            "address_2": "11",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "95202",
            "telephone_number": "209-670-6799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUPHANT SOCIETY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-31",
        "last_updated": "2015-08-31",
        "status": "A",
        "authorized_official_last_name": "GRAYSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "209-670-6799",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "CA",
            "license": "IMF 85548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bunnaun Uch
• Bunnaun Uch
• Zackaria Araissi Bunnell
• Yvette Bunting
• Mia Buonanno
• Justine Burbank
• Carol Marie Burch, MD
• Joe Gregory Burch, DMD
• Agustina Burciago
• Ashley Burdick

• Community/Behavioral Health Agency in Stockton, CA
• Providers in Stockton, CA by specialty
• Community/Behavioral Health Agency in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.