Bukaty, Lisa M

Bukaty, Lisa M is an individual health care provider with primary practice located at 1441 Avocado Ave Suite 309, Newport Beach CA 92660. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Bukaty, Lisa M can be contacted via phone (949) 644-8556.

Contact Information

Primary practice address
1441 Avocado Ave Suite 309 Newport Beach CA 92660
Phone: (949) 644-8556
Fax: (949) 644-6318
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X G72364 California

Profile Details

NPI number 1437245867
LBN Legal business name Bukaty, Lisa M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 5th, 2006
Last updated Jul 8th, 2007 - 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1437245867 NPPES
California Other 00G723640 BLUE SHIELD OF CALIFORNIA

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