Provider Demographics
NPI:1134495120
Name:JONATHAN E. BUGH D.C. INC.
Entity Type:Organization
Organization Name:JONATHAN E. BUGH D.C. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUSIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:805-484-7500
Mailing Address - Street 1:5239 MISSION OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-5403
Mailing Address - Country:US
Mailing Address - Phone:805-484-7500
Mailing Address - Fax:805-484-9495
Practice Address - Street 1:5239 MISSION OAKS BLVD
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93012-5403
Practice Address - Country:US
Practice Address - Phone:805-484-7500
Practice Address - Fax:805-484-9495
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-24
Last Update Date:2012-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC15501111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA15501Medicare UPIN