Basic Information
| Provider Information | |||||||||
| NPI: | 1528174174 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BUFFUM | ||||||||
| FirstName: | MARTHA | ||||||||
| MiddleName: | DAVIS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNSC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4150 CLEMENT ST | ||||||||
| Address2: | VA MEDICAL CENTER (118) | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941211545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152214810 | ||||||||
| FaxNumber: | 4157506971 | ||||||||
| Practice Location | |||||||||
| Address1: | 4150 CLEMENT ST | ||||||||
| Address2: | VA MEDICAL CENTER (118) | ||||||||
| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941211545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4152214810 | ||||||||
| FaxNumber: | 4157506971 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2006 | ||||||||
| LastUpdateDate: | 07/10/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0809X | 200357 | CA | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.