# JUDY L BOURGET MD INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1609181668
- **Authorized official:** DR. JUDY L BOURGET MD (OWNER)
- **Authorized official phone:** (949) 429-8760

## Contact information

- **Practice address:** 34052 LA PLZ, STE 104, DANA POINT, CA 92629-2587
- **Practice address phone:** (949) 429-8760
- **Practice address fax:** (949) 429-6909
- **Mailing address:** 34052 LA PLZ, STE 104, DANA POINT, CA 92629-2587
- **Mailing address phone:** (949) 429-8760
- **Mailing address fax:** (949) 429-6909

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | G72076 | CA | Yes |

## Other

- **Enumeration date:** 08/16/2010
- **Last updated:** 08/16/2010