Organization
GERARD H. BOGHOSSIAN, D.P.M., A PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BOGHOSSIAN DPM (OWNER)
(661) 726-3338
Entity
Organization
Contact information
Practice address
936 WEST AVE J-4, SUITE 104, LANCASTER, CA 93534
(661) 726-3338
(661) 949-9431
Mailing address
936 WEST AVE J-4, SUITE 104, LANCASTER, CA 93534
(661) 726-3338
(661) 949-9431
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
E4323
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000E43231
MEDI-CAL
CA
01
—
4281420002
NSC
CA
Enumeration date
04/01/2008
Last updated
06/23/2008
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