Active NPI
Norman Theodore Buetow
- General Practice Physician
- Glendale, CA
National Provider Identifier
1972534394
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Sep 20, 2012.
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- G40726
- Practice address
- 541 W Colorado St
Glendale, CA 91204-3638 - Phone
- (818) 638-8522
- NPI assigned
- Jul 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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | G40726 | CA | Primary |
Addresses
Primary practice location
541 W Colorado St
Glendale, CA 91204-3638
Mailing address
38465 Oaktree Loop
Murrieta, CA 92562-3009
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
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152057600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1972534394",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "38465 OAKTREE LOOP",
"city": "MURRIETA",
"state": "CA",
"postal_code": "925623009"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "541 W COLORADO ST",
"city": "GLENDALE",
"state": "CA",
"postal_code": "912043638",
"telephone_number": "818-638-8522"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUETOW",
"first_name": "NORMAN",
"middle_name": "THEODORE",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-05",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "CA",
"license": "G40726",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Glendale, 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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.