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Individual

GERARD H BOGHOSSIAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Contact information

Practice address
42135 10TH ST W, SUITE 101, LANCASTER, CA 93534-7095
(661) 726-5005
(661) 726-5377
Mailing address
42135 10TH ST W, SUITE 101, LANCASTER, CA 93534-7095
(661) 726-5005
(661) 726-5377

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E4323
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00E43231
MEDI-CAL
CA
Enumeration date
04/07/2006
Last updated
03/18/2014
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