Boudreaux, Don
Boudreaux, Don is an sole proprietor health care provider with primary practice located at 8420 Buckland St Apt 2 , La Mesa CA 91942-2874. He recently has only one registered license in Nursing Service Providers / Licensed Vocational Nurse, which is considered as his primary health care specialty. Boudreaux, Don can be contacted via phone (760) 470-4089.Contact Information
Primary practice address
8420 Buckland St Apt 2
La Mesa CA 91942-2874
Phone: (760) 470-4089
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Licensed Vocational Nurse | 164X00000X | VN174892 | California |
Profile Details
| NPI number | 1114177698 |
|---|---|
| LBN Legal business name | Boudreaux, Don |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 22nd, 2008 |
| Last updated | Sep 22nd, 2008 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114177698 | NPPES |
| California | MEDICAID | EPS014720 | |
| California | MEDICAID | RVN003060 |
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