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General NPI Number Information
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NPI Number | 1164893236
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Entity Type | Organization
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Legal Business Name | SWARAJ BOSE, MD, INC
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Dates
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Enumeration Date | 10/14/2015
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Last Update Date | 02/09/2017
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Provider Practice Location Address
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Address Line | 8631 W 3RD ST SUITE 200E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-469-9080
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Fax | 310-469-9085
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Provider Business Mailing Address
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Address Line | 8631 W 3RD ST SUITE 200E
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City | LOS ANGELES
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State | CA
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Zip | 90048-5901
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Country | US
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Telephone | 310-469-9080
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Fax | 310-469-9085
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Authorized Official
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Title or Position | CEO
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Name | SWARAJ BOSE
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Credential | M.D.
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Telephone | 310-469-9080
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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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