Boucher, Michael D

Boucher, Michael D is an individual health care provider with primary practice located at 29997 Canyon Hills Rd Ste 1604 , Lake Elsinore CA 92532. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Boucher, Michael D can be contacted via phone (951) 244-2224.

Contact Information

Primary practice address
29997 Canyon Hills Rd Ste 1604 Lake Elsinore CA 92532
Phone: (951) 244-2224
Fax: (951) 244-1244
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 51420 California

Profile Details

NPI number 1386068310
LBN Legal business name Boucher, Michael D
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 11th, 2014
Last updated Sep 7th, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386068310 NPPES
Nevada Other P01718733 RAILROAD MEDICARE
Nevada MEDICAID 1386068310 RAILROAD MEDICARE

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