# MARY BOS, D.O., A MEDICAL CORPORATION

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

## Provider details

- **NPI number:** 1922469915
- **Authorized official:** MRS. PATTI RIVERA (BILLING MANAGER)
- **Authorized official phone:** (951) 719-3330

## Contact information

- **Practice address:** 1200 ROSECRANS AVE, STE 110, MANHATTAN BEACH, CA 90266-2462
- **Practice address phone:** (424) 220-4415
- **Mailing address:** PO BOX 1007, MURRIETA, CA 92564-1007
- **Mailing address phone:** (951) 719-3330
- **Mailing address fax:** (951) 296-6741

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207XS0106X | Orthopaedic Hand Surgery Physician | 20A7009 | CA | Yes |

## Other

- **Enumeration date:** 03/17/2016
- **Last updated:** 03/17/2016