Healthcare Provider Details

I. General information

NPI: 1033031927
Provider Name (Legal Business Name): JOHN BOUZ DO, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 W SAN BERNARDINO RD
COVINA CA
91723-1515
US

IV. Provider business mailing address

428 CANNON AVE
SAN DIMAS CA
91773-3645
US

V. Phone/Fax

Practice location:
  • Phone: 626-331-7331
  • Fax:
Mailing address:
  • Phone: 626-353-4636
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number State

VIII. Authorized Official

Name: JOHN BOUZ
Title or Position: OWNER
Credential: DO
Phone: 626-353-4636