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General NPI Number Information
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NPI Number | 1134495120
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Entity Type | Organization
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Legal Business Name | JONATHAN E. BUGH D.C. INC.
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Dates
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Enumeration Date | 03/24/2012
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Last Update Date | 04/23/2012
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Provider Practice Location Address
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Address Line | 5239 MISSION OAKS BLVD
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City | CAMARILLO
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State | CA
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Zip | 93012-5403
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Country | US
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Telephone | 805-484-7500
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Fax | 805-484-9495
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Provider Business Mailing Address
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Address Line | 5239 MISSION OAKS BLVD
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City | CAMARILLO
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State | CA
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Zip | 93012-5403
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Country | US
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Telephone | 805-484-7500
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Fax | 805-484-9495
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | SUSIE BUGH
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Credential |
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Telephone | 805-484-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | DC15501
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License Number State | CA
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