Basic Information
Provider Information
NPI: 1639213317
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BUECHLER
FirstName: VICTOR
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: M.S.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2550 E FOOTHILL BLVD
Address2:  
City: PASADENA
State: CA
PostalCode: 911073406
CountryCode: US
TelephoneNumber: 6267445230
FaxNumber:  
Practice Location
Address1: 10416 LOWER AZUSA RD
Address2:  
City: EL MONTE
State: CA
PostalCode: 917311208
CountryCode: US
TelephoneNumber: 6266520755
FaxNumber: 6264331318
Other Information
ProviderEnumerationDate: 02/16/2007
LastUpdateDate: 07/18/2013
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800X  Y Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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