Mumford, Lisa Bourbeau
Mumford, Lisa Bourbeau is an individual health care provider with primary practice located at 833 Broadway Suite 100, El Cajon CA 92021-4668. She recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics is her primary health care specialty. Mumford, Lisa Bourbeau can be contacted via phone (619) 447-7774.Contact Information
Primary practice address
833 Broadway Suite 100
El Cajon CA 92021-4668
Phone: (619) 447-7774
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | PT 20702 | California |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Pediatrics | 2251P0200X | PT 20702 | California |
Profile Details
| NPI number | 1730328600 |
|---|---|
| LBN Legal business name | Mumford, Lisa Bourbeau |
| Credentials | Physical Therapist (PT) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 16th, 2009 |
| Last updated | Feb 16th, 2009 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730328600 | NPPES |
| California | Other | PT 20702 | PHYSICAL THERAPY |
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