Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gary Tyler Buckholz, MD

Individual provider Family Medicine Physician · NPI 1174601702

Gary Tyler Buckholz, MD is a Family Medicine Physician in San Diego, California. Licensed in California. Registered with an NPI since 2006.

Licensed in
CA
In the registry since
2006
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4311 Third Ave
San Diego, CA 92103-1407
Phone: (619) 688-1600
Fax: (619) 278-6163
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Hospice and Palliative Medicine (Family Medicine) Physician (primary) Taxonomy 207QH0002X · Licence A82836 (CA)
Family Medicine Physician Taxonomy 207Q00000X · Licence A82836 (CA)

Record details

NPI number1174601702
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedNovember 1, 2006
Last updated in NPPESAugust 16, 2017

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