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Organization
BRYAN L. BERGHOUT, DPM PC
Active
Organization
BRYAN L. BERGHOUT, DPM PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRYAN LEONARD BERGHOUT DPM (OWNER PRESIDENT)
(949) 433-5262
Entity
Organization
Contact information
Practice address
629 CAMINO DE LOS MARES STE 207, SAN CLEMENTE, CA 92673-2832
(949) 433-5262
(425) 225-5458
Mailing address
3600 158TH PL SE, BOTHELL, WA 98012-4750
(949) 433-5262
(425) 225-5458
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4205
CA
Other
Enumeration date
10/16/2006
Last updated
08/22/2020
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