Bourgoin, Michael Paul

Bourgoin, Michael Paul is an individual health care provider with primary practice located at 1835 Newport Blvd Suite A-111, Costa Mesa CA 92627-5031. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Bourgoin, Michael Paul can be contacted via phone (949) 646-4949.

Contact Information

Primary practice address
1835 Newport Blvd Suite A-111 Costa Mesa CA 92627-5031
Phone: (949) 646-4949
Fax: (949) 646-2533
Website:
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Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 9870T California

Profile Details

NPI number 1720197361
LBN Legal business name Bourgoin, Michael Paul
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 29th, 2006
Last updated Nov 2nd, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1720197361 NPPES
California Other 1548472921 GROUP NPI
California Other 9870T GROUP NPI
California Other WOP9870I GROUP NPI

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