Provider Demographics
NPI:1699774406
Name:BUCHHOLZ, WILLIAM MAXWELL (MD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:MAXWELL
Last Name:BUCHHOLZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1174 CASTRO ST
Mailing Address - Street 2:SUITE 275
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-2568
Mailing Address - Country:US
Mailing Address - Phone:650-988-8011
Mailing Address - Fax:650-988-8012
Practice Address - Street 1:851 FREMONT AVE
Practice Address - Street 2:#104
Practice Address - City:LOS ALTOS
Practice Address - State:CA
Practice Address - Zip Code:94024-5698
Practice Address - Country:US
Practice Address - Phone:650-980-1982
Practice Address - Fax:650-229-1011
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2013-07-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG-23475207R00000X, 207RH0000X, 207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A41960Medicare UPIN
CA00G234750Medicare ID - Type Unspecified