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General NPI Number Information
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NPI Number | 1174504013
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Entity Type | Individual
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Provider Name | ALOK K. BOSE MD
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Gender | Male
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Dates
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Enumeration Date | 11/08/2005
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Last Update Date | 07/26/2012
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Provider Practice Location Address
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Address Line | 5030 BUSINESS CENTER DR SUITE 230
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City | FAIRFIELD
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State | CA
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Zip | 94534-6874
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Country | US
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Telephone | 707-863-8190
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Fax | 707-863-8193
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Provider Business Mailing Address
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Address Line | 118 SAGE WAY
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City | NAPA
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State | CA
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Zip | 94559-3574
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2080P0202X
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Taxonomy Name | Pediatric Cardiology Physician
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License Number | A80991
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License Number State | CA
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