Bryan L. Berghout

Primary specialty

Foot & Ankle Surgery PodiatristTaxonomy code 213ES0103X

License

E4205 Issued in CA

Legal business name

BRYAN L. BERGHOUT

Practice address

629 Camino de Los Mares Ste 207
San Clemente, CA 92673-2832

Phone

(949) 433-5262

Fax

(425) 225-5458

NPI assigned

Dec 19, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Bryan Leonard Berghout, D.P.M.

Title

Owner

Phone

(949) 433-5262

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1166486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962566703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 158TH PL SE",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980124750",
            "telephone_number": "949-433-5262",
            "fax_number": "425-225-5458"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 CAMINO DE LOS MARES STE 207",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926732832",
            "telephone_number": "949-433-5262",
            "fax_number": "425-225-5458"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN L. BERGHOUT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BERGHOUT",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "LEONARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "949-433-5262",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.P.M."
    },
    "taxonomies": [
        {
            "code": "213ES0103X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Podiatrist, Foot & Ankle Surgery",
            "state": "CA",
            "license": "E4205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greg A Brown, M.D.
• Nancy Krehbiel Brownell, MD
• William Jackson Brownson, D.D.S.
• Deborah Laura Brownstone, M.D.
• Richard Deen-Francis Bruce, PA-C, MPAP
• Bryan L. Berghout, DPM PC
• Carla Peterson Bryan, DDS
• Breana Buccheri, OTR
• David Buchan, DDS
• Samantha Buchanan, BCBA

• Foot & Ankle Surgery Podiatrist in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Foot & Ankle Surgery Podiatrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.