Individual
DON BOUDREAUX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8420 BUCKLAND ST APT 2, LA MESA, CA 91942-2874
(760) 470-4089
Mailing address
8420 BUCKLAND ST APT 2, LA MESA, CA 91942-2874
(760) 470-4089
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
VN174892
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EPS014720
—
CA
05
—
RVN003060
—
CA
Enumeration date
09/22/2008
Last updated
09/22/2008
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