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General NPI Number Information
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NPI Number | 1255434544
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Entity Type | Individual
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Provider Name | THOMAS A BOSMA PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/05/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 504 W PUEBLO ST SUITE 102
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City | SANTA BARBARA
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State | CA
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Zip | 93105-6211
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Country | US
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Telephone | 805-687-7719
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Fax | 805-682-2971
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Provider Business Mailing Address
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Address Line | PO BOX 1206
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City | GOLETA
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State | CA
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Zip | 93116-1206
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Country | US
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Telephone | 805-964-3838
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Fax | 805-683-3400
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | PA18561
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License Number State | CA
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