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General NPI Number Information
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NPI Number | 1780252213
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Entity Type | Individual
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Provider Name | NIKHIL BOGA DPM
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Gender | Male
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Dates
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Enumeration Date | 06/11/2021
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 961 LAUREL ST
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City | SAN CARLOS
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State | CA
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Zip | 94070-3949
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Country | US
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Telephone | 650-593-8083
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Fax |
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Provider Business Mailing Address
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Address Line | 32 ALBATROSS CT
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City | CAMPBELL
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State | CA
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Zip | 95008-1265
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Country | US
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Telephone | 469-777-0865
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E6040
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License Number State | CA
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