Provider Demographics
NPI:1902959786
Name:BUCK, JAMES ANDREW (PA-C)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ANDREW
Last Name:BUCK
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1580 VALENCIA ST
Mailing Address - Street 2:SUITE 703
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4423
Mailing Address - Country:US
Mailing Address - Phone:415-642-0707
Mailing Address - Fax:415-648-7988
Practice Address - Street 1:1580 VALENCIA ST
Practice Address - Street 2:SUITE 703
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110
Practice Address - Country:US
Practice Address - Phone:415-642-0707
Practice Address - Fax:415-648-7988
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2014-12-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPA15831363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant