# KELLEEN BOSCH DO INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1306018452
- **Authorized official:** MRS. MARY KATHLEEN HANSEN (ADMINISTRATOR)
- **Authorized official phone:** (559) 981-2600

## Contact information

- **Practice address:** 1374 E ALLUVIAL AVE, FRESNO, CA 93720-2608
- **Practice address phone:** (559) 981-2600
- **Practice address fax:** (559) 981-2610
- **Mailing address:** 1374 E ALLUVIAL AVE, FRESNO, CA 93720-2608
- **Mailing address phone:** (559) 981-2600
- **Mailing address fax:** (559) 981-2610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207V00000X | Obstetrics & Gynecology Physician | 20A9211 | CA | Yes |

## Other

- **Enumeration date:** 03/28/2008
- **Last updated:** 09/18/2013