DR. JUDY LYNN BOURGET MD NPI 1073593240

NPI Information

  • NPI: 1073593240
  • Provider Name: DR. JUDY LYNN BOURGET, MD
  • Classification: General Practice - 208D00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • CLIA Number: 05D2005557
  • Address: 34052 LA PLZ
    SUITE 104
    DANA POINT, CA
    ZIP 92629
  • Phone: (949) 429-8760

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NPI Details

DR. Judy Lynn Bourget, MD is a general practice in Dana Point, CA with 36 years of experience. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee DR. Judy Lynn Bourget, MD NPI is 1073593240. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF NEVADA SCHOOL OF MEDICINE
Graduation Year:1990

The provider's business location address is:

34052 LA PLZ
SUITE 104
DANA POINT, CA
ZIP 92629-587
Phone: (949) 429-8760
Fax: (949) 429-6909

The NPI 1073593240 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D2005557 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)

The enumeration date for this NPI number is 1/22/2006 and was last updated on 2/3/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1208600000XSurgeryG72076CALIFORNIANo
2208D00000XGeneral PracticeG72076CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1G96136MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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