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Individual
MICHAEL BOGGS
Active
Individual
MICHAEL BOGGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OPT8427
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
205153800
US DEPT. OF LABOR
CA
01
—
8427T
CHAMPUS
CA
01
—
WOP84270
DMERC
CA
Enumeration date
06/26/2006
Last updated
12/08/2020
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