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Deactivated NPI 1720312226 Deactivated / Inactive NPI Male Practitioner

Greg Bourque , LAC

Acupuncturist • San Diego, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Greg Bourque has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date September 30, 2009
NPI Deactivation Date February 11, 2022
Total Practice Duration ~13 Years of Practice (2009 – 2022)

Professional Overview & Biography Verified Profile Summary

Greg Bourque, LAC was a registered Acupuncturist practicing in San Diego, CA. Throughout an active medical career spanning 13 years, Greg Bourque provided care at the practice location at 4010 SORRENTO VALLEY BLVD until profile deactivation on 2022-02-11.

Practice Location & Contact Primary Location

Practice Address

4010 Sorrento Valley Blvd
Suite 300

San Diego, CA 921211432

Telephone 8587937860
Fax 8587937863
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Acupuncturist in San Diego, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 26.0 Yrs
State Avg: 20.5 Yrs
Regional Practice Density
686 Specialists

Practicing in San Diego, CA (11031 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Acupuncturist Primary Specialty

NUCC Taxonomy Code: 171100000X

State License CA AC7309

An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners
Dr. Linda Greene , DPT

Physical Therapist

NPI 1093257818

Doctor of Physical Therapy

Dr. Kirsten Roberts , DPT

Physical Therapist

NPI 1144537390

Doctor of Physical Therapy

Dr. Jonathan Koretoff , MD

Family Medicine - Sports Medicine

NPI 1346668779

Doctor of Medicine (M.D.)

Dr. James Toldi , DO

Family Medicine - Sports Medicine

NPI 1487913588

Doctor of Osteopathic Medicine (D.O.)

Dr. Melissa Burman , MD

Internal Medicine - Sports Medicine

NPI 1881198166

Doctor of Medicine (M.D.)

Dr. Frederick Richburg , MD

Family Medicine - Sports Medicine

NPI 1881798221

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

9 Historical Events
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NPI Profile Deactivated February 11, 2022

Record deactivated on February 11, 2022

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Updated Practice Location December 05, 2019

Registered at 6973 LINDA VISTA RD, SAN DIEGO, CA 921116342 (Tel: 8582790925)

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Updated Business Mailing Address December 05, 2019

Registered at 6973 LINDA VISTA RD, SAN DIEGO, CA 921116342 (Tel: 8582780925)

NPI Profile Active February 15, 2011

NPI status registered as active in NPPES database

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Updated Practice Location February 15, 2011

Registered at 4010 SORRENTO VALLEY BLVD, SUITE 300, SAN DIEGO, CA 921211432 (Tel: 8587937860)

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Updated Business Mailing Address February 15, 2011

Registered at 4010 SORRENTO VALLEY BLVD, SUITE 300, SAN DIEGO, CA 921211432 (Tel: 8587937860)

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Provider Name / Credentials Updated February 15, 2011

Recorded as GREG BOURQUE, L.AC.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 15, 2011

Acupuncturist (License #AC7309 in CA)

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Initial NPI Registration & Enumeration September 30, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1720312226
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 30, 2009
Last Update: February 15, 2011
Deactivation Date: February 11, 2022

Mailing Address

4010 Sorrento Valley Blvd, Suite 300

San Diego, CA 921211432

Phone: 8587937860

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.