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Individual

JOHN SCOTT BOSWELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
6730 N WEST AVE, FRESNO, CA 93711-4301
(559) 439-3000
(559) 439-3004
Mailing address
6730 N WEST AVE, FRESNO, CA 93711-4301
(559) 439-3000
(559) 439-3004

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A100542
CA
207NS0135X
Procedural Dermatology Physician
A100542
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0A1005420
BLUE SHIELD
CA
Enumeration date
05/30/2007
Last updated
08/02/2023
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