Richard L Buccigross MD a Medical Corporation

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

G31185 Issued in CA

Legal business name

RICHARD L BUCCIGROSS MD A MEDICAL CORPORATION

Practice address

4550 Kearny Villa Rd
Suite 214
San Diego, CA 92123-1578

Phone

(858) 565-0900

NPI assigned

Feb 4, 2009

Last updated

Feb 4, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Richard Leslie Buccigross, M.D.NPI 1124138672

Title

President

Phone

(858) 565-0900

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Richard L Buccigross, MD

  • Psychiatry Physician
  • San Diego, CA
  • NPI 1124138672
  NPD (past) Authorized official

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

{
    "created_epoch": "1233705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233705600000",
    "number": "1841438413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4550 KEARNY VILLA RD",
            "address_2": "SUITE 214",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231578",
            "telephone_number": "858-565-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4550 KEARNY VILLA RD",
            "address_2": "SUITE 214",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921231578",
            "telephone_number": "858-565-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD L BUCCIGROSS MD A MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-04",
        "last_updated": "2009-02-04",
        "status": "A",
        "authorized_official_last_name": "BUCCIGROSS",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "LESLIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "858-565-0900",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "CA",
            "license": "G31185",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G311850",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Child & Adolescent Psychiatry Physician in San Diego, CA
• Providers in San Diego, CA by specialty
• Child & Adolescent Psychiatry Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2009; 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.