Healthcare Provider Details

I. General information

NPI: 1891664421
Provider Name (Legal Business Name): NAZAR BOGHOSIAN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/03/2025
Certification Date: 11/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

747 HOWARD ST
SAN FRANCISCO CA
94103-3118
US

IV. Provider business mailing address

747 HOWARD ST
SAN FRANCISCO CA
94103-3118
US

V. Phone/Fax

Practice location:
  • Phone: 888-912-7693
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number0894-1658-7324
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: