Individual
DR. JOHN RODERICK TEN BOSCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
5755 COTTLE RD BLDG 6, SAN JOSE, CA 95123-3640
(408) 972-6752
Mailing address
5755 COTTLE RD BLDG 6, SAN JOSE, CA 95123-3640
Taxonomy
Speciality
Code
Description
License number
State
207SC0300X
Clinical Cytogenetics Physician
MTO653
CA
207SG0203X
Clinical Molecular Genetics Physician
Primary
DRN64
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2009152
AMERICAN BOARD OF MEDICAL GENETICS
CA
01
—
DRN64
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH - LAB FIELD SERVICES
CA
01
—
MTO653
CALIFORNIA DEPARTMENT OF PUBLIC HEALTH - LAB FIELD SERVICES
CA
Enumeration date
05/08/2013
Last updated
05/08/2013
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