Individual provider Active NPI

Edward Leonard Busch, M.D.

  • Surgery Physician
  • San Diego, CA
National Provider Identifier
1720001241
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
C94411 Issued in TX
Practice address
8810 Rio San Diego Dr
San Diego, CA 92108-1622
Phone
(619) 400-5026
Fax
(619) 400-5031
NPI assigned
Jul 25, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X C94411 TX Primary

Addresses

Primary practice location

8810 Rio San Diego Dr
San Diego, CA 92108-1622

Mailing address

11650 Calle Paracho
San Diego, CA 92128-3313
Phone (858) 521-0443

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)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
C94411TXMDSurgery Physician

NPI Registry JSON

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

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720001241",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11650 CALLE PARACHO",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921283313",
            "telephone_number": "858-521-0443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8810 RIO SAN DIEGO DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921081622",
            "telephone_number": "619-400-5026",
            "fax_number": "619-400-5031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUSCH",
        "first_name": "EDWARD",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "C94411",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.