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General NPI Number Information
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NPI Number | 1841350147
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Entity Type | Individual
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Provider Name | JOHN ROGER KOSBAU D.C.
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2220 J ST STE 3
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City | SACRAMENTO
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State | CA
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Zip | 95816-4741
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Country | US
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Telephone | 916-443-2255
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Fax | 916-443-2292
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Provider Business Mailing Address
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Address Line | 9345 WELLINGTON WAY
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City | GRANITE BAY
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State | CA
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Zip | 95746-6636
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Country | US
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Telephone | 916-773-2292
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Fax | 916-773-2292
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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 | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | DC14849
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License Number State | CA
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