Individual
JEFFREY BOGNOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5901 E 7TH ST, LONG BEACH, CA 90822-5201
(562) 826-8000
Mailing address
7785 11TH ST, BUENA PARK, CA 90621-3450
(714) 262-5205
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
701330
CA
Other
Enumeration date
08/20/2019
Last updated
08/20/2019
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