Organization
BOZUK & ASSOCIATES SURGICAL, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL IVAN BOZUK M.D. (PHYSICIAN)
(707) 763-3967
Entity
Organization
Contact information
Practice address
1456 PROFESSIONAL DR, STE. #404, PETALUMA, CA 94954-6639
(707) 763-3967
(707) 765-0554
Mailing address
1456 PROFESSIONAL DR, STE. #404, PETALUMA, CA 94954-6639
(707) 763-3967
(707) 765-0554
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
A73703
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A737030
—
CA
Enumeration date
01/30/2007
Last updated
08/22/2020
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