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General NPI Number Information
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NPI Number | 1255358800
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Entity Type | Organization
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Legal Business Name | ELISABETH A. BOSSINGHAM, M.D., INC
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Dates
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Enumeration Date | 07/17/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 1827 S COURT ST SUITE F
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City | VISALIA
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State | CA
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Zip | 93277-5469
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Country | US
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Telephone | 559-622-0800
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Fax | 559-622-0801
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Provider Business Mailing Address
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Address Line | 1827 S COURT ST SUITE F
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City | VISALIA
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State | CA
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Zip | 93277-5469
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Country | US
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Telephone | 559-622-0800
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Fax | 559-622-0801
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELISABETH A. BOSSINGHAM
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Credential | M.D.
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Telephone | 559-622-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | G69388
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License Number State | CA
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