Bourgon, Douglas Rene

Bourgon, Douglas Rene is an individual health care provider with primary practice located at 450 Stanyan St , San Francisco CA 94117-1019. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Diagnostic Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Bourgon, Douglas Rene can be contacted via phone (415) 750-5687.

Contact Information

Primary practice address
450 Stanyan St San Francisco CA 94117-1019
Phone: (415) 750-5687
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 985247 California
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X A85247 California

Profile Details

NPI number 1730138876
LBN Legal business name Bourgon, Douglas Rene
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 8th, 2006
Last updated Jul 9th, 2015 - about 9 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 1730138876 NPPES
Other P00248458 RAILROAD MEDICARE PIN
MEDICAID 00A852470 RAILROAD MEDICARE PIN

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