Buen Vita IV Med Spa Professional Corporation

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

BUEN VITA IV MED SPA PROFESSIONAL CORPORATION

Doing business as

Buen Vita IV Med Spa

Practice address

2330 Colorado Ave
Turlock, CA 95382-2013

Phone

(209) 250-2535

Fax

(209) 633-3433

NPI assigned

Sep 19, 2024

Last updated

Jan 9, 2025By 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

Dr. Jose Buenrostro, MDNPI 1861839151

Title

Medical Director

Phone

(209) 250-2535

Specialties & licenses 1

Addresses

Other names 1

• BUEN VITA IV MED SPA Doing business as

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Locations

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.

• Jose Ignacio Buenrostro, M.D.

  • Family Medicine Physician
  • Atwater, CA
  • NPI 1861839151
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1726704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736380800000",
    "number": "1902633126",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 COLORADO AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822013",
            "telephone_number": "209-250-2535",
            "fax_number": "209-633-3433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 COLORADO AVE",
            "city": "TURLOCK",
            "state": "CA",
            "postal_code": "953822013",
            "telephone_number": "209-250-2535",
            "fax_number": "209-633-3433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BUEN VITA IV MED SPA PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-19",
        "last_updated": "2025-01-09",
        "certification_date": "2025-01-09",
        "status": "A",
        "authorized_official_last_name": "BUENROSTRO",
        "authorized_official_first_name": "JOSE",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "209-250-2535",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BUEN VITA IV MED SPA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Elizabeth Briseno
• Diane Michelle Britain
• Ashley Ann Brown
• Alicia Bruffett
• Bryan L Green (Posey's Hearing Aid Center)
• Karla Sofia Buenrostro, FNP
• Shantelle Noel Buethe, M.A.
• Hiep P Bui, NP-C
• Russell Bunting, PTA
• Arik Burgin, M.D.

• Family Medicine Physician in Turlock, CA
• Providers in Turlock, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.