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General NPI Number Information
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NPI Number | 1396576187
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Entity Type | Individual
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Provider Name | MICHAEL BOSIO
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Gender | Male
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Dates
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Enumeration Date | 08/12/2024
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 1057 E GRAND AVE
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City | ARROYO GRANDE
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State | CA
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Zip | 93420-2504
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Country | US
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Telephone | 805-270-1700
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Fax | 805-481-7097
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Provider Business Mailing Address
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Address Line | 2050 S BLOSSER RD
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City | SANTA MARIA
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State | CA
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Zip | 93458-7310
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Country | US
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Telephone | 805-361-8030
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Fax | 805-361-8097
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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