Active NPI
Jose Benavidez Bueno, M.D.
- Emergency Medicine Physician
- Apple Valley, CA
National Provider Identifier
1386730760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Emergency Medicine Physician
- License
- DO019480
- Practice address
- 19273 Kanbridge St
Apple Valley, CA 92308-6071 - Phone
- (760) 912-1613
- NPI assigned
- Oct 5, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medicine Physician | 207P00000X | DO019480 | MD | Primary |
Addresses
Primary practice location
19273 Kanbridge St
Apple Valley, CA 92308-6071
Mailing address
19273 Kambridge Street
Apple Valley
Apple Valley, CA 92308
Phone (760) 912-1613
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DO019480 | MD | MD | Emergency Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1160006400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406678400000",
"number": "1386730760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19273 KAMBRIDGE STREET",
"address_2": "APPLE VALLEY",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "92308",
"telephone_number": "760-912-1613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19273 KANBRIDGE ST",
"city": "APPLE VALLEY",
"state": "CA",
"postal_code": "923086071",
"telephone_number": "760-912-1613"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUENO",
"first_name": "JOSE",
"middle_name": "BENAVIDEZ",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-10-05",
"last_updated": "2014-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "207P00000X",
"taxonomy_group": "",
"desc": "Emergency Medicine",
"state": "MD",
"license": "DO019480",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Apple Valley, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.