Provider Demographics
NPI:1942059266
Name:BUESCHER, MEREDITH JOAN (PA-C)
Entity type:Individual
Prefix:
First Name:MEREDITH
Middle Name:JOAN
Last Name:BUESCHER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5426 CORONADA DR
Mailing Address - Street 2:
Mailing Address - City:MENTOR ON THE LAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44060-1406
Mailing Address - Country:US
Mailing Address - Phone:440-975-6423
Mailing Address - Fax:
Practice Address - Street 1:1700 E CESAR CHAVEZ AVE
Practice Address - Street 2:SUITE 2500
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033
Practice Address - Country:US
Practice Address - Phone:323-306-9632
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-17
Last Update Date:2024-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA64099363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant