La Bourene, Jay I.

La Bourene, Jay I. is an sole proprietor health care provider with primary practice located at 1550-G Tiburon Blvd , Tiburon CA 94920. He recently has only one registered license in Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery), which is considered as his primary health care specialty. La Bourene, Jay I. can be contacted via phone (415) 833-2000.

Contact Information

Primary practice address
1550-G Tiburon Blvd Tiburon CA 94920
Phone: (415) 833-2000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Thoracic Surgery (Cardiothoracic Vascular Surgery) 208G00000X G79536 California

Profile Details

NPI number 1215015847
LBN Legal business name La Bourene, Jay I.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 1st, 2006
Last updated Dec 4th, 2018 - about 7 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 1215015847 NPPES
California Other 1225508385 NPI-TYPE 2
California MEDICAID 00G795360 NPI-TYPE 2

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