Healthcare Provider Details

I. General information

NPI: 1780642884
Provider Name (Legal Business Name): WILLIAM DICK BUGBEE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 03/10/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10666 NORTH TORREY PINES RD
LA JOLLA CA
92037-1027
US

IV. Provider business mailing address

10666 NORTH TORREY PINES RD
LA JOLLA CA
92037-1027
US

V. Phone/Fax

Practice location:
  • Phone: 858-554-7993
  • Fax: 858-554-6321
Mailing address:
  • Phone: 858-554-7993
  • Fax: 858-554-6321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License NumberG66930
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: