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NPI Code Detail

MEDICARE: JAMES ALAN BOURGEOIS M.D.

MEDICARE: JAMES ALAN BOURGEOIS M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianR3279TX
22084P0800XPsychiatry PhysicianG78627CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982686374
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMES ALAN BOURGEOIS M.D.
Provider Business Mailing Address
First Line : UNIVERSITY OF CALIFORNIA, DAVIS
Second Line : 2230 STOCKTON BOULEVARD
City : SACRAMENTO
State : CA
Zip : 95817-4658
Country : US
Telephone Number : 415-328-2821
Fax Number :
Provider Business Practice Location Address
First Line : 2230 STOCKTON BLVD
Second Line :
City : SACRAMENTO
State : CA
Zip : 95817-1353
Country : US
Telephone Number : 415-328-2821
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/19/2005
Last Update Date : 10/26/2022

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