# GERARD H. BOGHOSSIAN, D.P.M., A PROFESSIONAL CORPORATION

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

## Provider details

- **NPI number:** 1366614141
- **Authorized official:** GARY BOGHOSSIAN DPM (OWNER)
- **Authorized official phone:** (661) 726-3338

## Contact information

- **Practice address:** 936 WEST AVE J-4, SUITE 104, LANCASTER, CA 93534
- **Practice address phone:** (661) 726-3338
- **Practice address fax:** (661) 949-9431
- **Mailing address:** 936 WEST AVE J-4, SUITE 104, LANCASTER, CA 93534
- **Mailing address phone:** (661) 726-3338
- **Mailing address fax:** (661) 949-9431

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 213ES0103X | Foot & Ankle Surgery Podiatrist | E4323 | CA | Yes |

## Other

- **Enumeration date:** 04/01/2008
- **Last updated:** 06/23/2008