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General NPI Number Information
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NPI Number | 1447644893
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Entity Type | Organization
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Legal Business Name | RICHARD P BOZNER OD INC
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Dates
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Enumeration Date | 03/24/2015
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Last Update Date | 03/24/2015
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Provider Practice Location Address
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Address Line | 4212 MARKET ST
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City | RIVERSIDE
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State | CA
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Zip | 92501-3516
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Country | US
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Telephone | 951-684-9700
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Fax | 951-684-4515
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Provider Business Mailing Address
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Address Line | 4212 MARKET ST
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City | RIVERSIDE
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State | CA
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Zip | 92501-3516
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Country | US
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Telephone | 951-684-9700
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Fax | 951-684-4515
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. RICHARD PAUL BOZNER
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Credential | O.D.
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Telephone | 951-684-9700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 7140T
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License Number State | CA
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