Healthcare Provider Details

I. General information

NPI: 1164719829
Provider Name (Legal Business Name): FLORIAN ALEXANDER BOSCHI MSOM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2011
Last Update Date: 07/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1062 S ROBERTSON BLVD
LOS ANGELES CA
90035-1505
US

IV. Provider business mailing address

1062 S ROBERTSON BLVD
LOS ANGELES CA
90035-1505
US

V. Phone/Fax

Practice location:
  • Phone: 310-279-3841
  • Fax:
Mailing address:
  • Phone: 310-279-3841
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number9889
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: