Provider Demographics
NPI:1871882035
Name:BUGAILISKIS, CHERYL-LYNN MARIE (MD)
Entity type:Individual
Prefix:DR
First Name:CHERYL-LYNN
Middle Name:MARIE
Last Name:BUGAILISKIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E BALBOA BLVD APT A
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92661-1180
Mailing Address - Country:US
Mailing Address - Phone:847-840-1784
Mailing Address - Fax:
Practice Address - Street 1:116 E BALBOA BLVD APT A
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92661-1180
Practice Address - Country:US
Practice Address - Phone:847-840-1784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-03-28
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program