Judy L Bourget MD Inc

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

G72076 Issued in CA

Legal business name

JUDY L BOURGET MD INC

Practice address

34052 La PLZ
Ste 104
Dana Point, CA 92629-2587

Phone

(949) 429-8760

Fax

(949) 429-6909

NPI assigned

Aug 16, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Judy L Bourget, MDNPI 1073593240

Title

Owner

Phone

(949) 429-8760

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Judy Lynn Bourget, MD

  • General Practice Physician
  • Dana Point, CA
  • NPI 1073593240
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1281916800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281916800000",
    "number": "1609181668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "34052 LA PLZ",
            "address_2": "STE 104",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926292587",
            "telephone_number": "949-429-8760",
            "fax_number": "949-429-6909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34052 LA PLZ",
            "address_2": "STE 104",
            "city": "DANA POINT",
            "state": "CA",
            "postal_code": "926292587",
            "telephone_number": "949-429-8760",
            "fax_number": "949-429-6909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JUDY L BOURGET MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-16",
        "last_updated": "2010-08-16",
        "status": "A",
        "authorized_official_last_name": "BOURGET",
        "authorized_official_first_name": "JUDY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-429-8760",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "General Practice",
            "state": "CA",
            "license": "G72076",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeffrey R Kindseth DDS Apc
• Noorani Jiwani, L.AC., D.A.O.M.
• Joanne Karla Gabot-Heyman DDS Inc
• Lana Lee Jones, PH.D., L.M.F.T.
• Joseph Giacopelli
• Micah Kalua, DPT
• Gayle B Kaminsky, LMFT
• Evonne Kanengieter, L.AC.
• Marjan Karimabadi, M.D
• Kathleen Farinacci MD and Lee N Sandler MD a Med Corp

• General Practice Physician in Dana Point, CA
• Providers in Dana Point, CA by specialty
• General Practice Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.