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General NPI Number Information
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NPI Number | 1144828690
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Entity Type | Organization
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Legal Business Name | BOGHOSSIAN VISION, A PROFESSIONAL MEDICAL CORPORATION
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Dates
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Enumeration Date | 10/15/2020
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Last Update Date | 10/15/2020
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Provider Practice Location Address
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Address Line | 3380 BLACKHAWK PLAZA CIR STE 200
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City | DANVILLE
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State | CA
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Zip | 94506-4910
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Country | US
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Telephone | 925-736-5959
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Fax | 925-886-5521
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Provider Business Mailing Address
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Address Line | 3380 BLACKHAWK PLAZA CIR STE 200
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City | DANVILLE
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State | CA
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Zip | 94506-4910
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Country | US
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Telephone | 925-736-5959
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Fax | 925-886-5521
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. ALLEN BOGHOSSIAN
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Credential | DO
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Telephone | 925-736-5959
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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