Individual
CHRYSTAL L BOUGON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
610 E. CAMPBELL AVE, SUITE 10A, CAMPBELL, CA 95008
(408) 712-3809
Mailing address
610 E. CAMPBELL AVE, SUITE 10A, CAMPBELL, CA 95008
(408) 712-3809
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
L9647
CA
Other
Enumeration date
05/17/2023
Last updated
05/17/2023
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