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Individual
JAMES WARREN BOOZER
Active
Individual
JAMES WARREN BOOZER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
G55121
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110065867
RAILROAD MEDICARE
CA
01
—
CD069A
GROUP MEDICARE PTAN
CA
01
—
CD143Z
INDIVIDUAL PTAN- MEDICARE
CA
01
—
ZZZ48224Z
MEDICARE IDENTIFICATION #
CA
Enumeration date
10/10/2005
Last updated
01/17/2017
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