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General NPI Number Information
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NPI Number | 1871638007
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Entity Type | Individual
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Provider Name | SUSAN E BOGAR CNM, RNP, MSN
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Gender | Female
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 323 N PRAIRIE AVE
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City | INGLEWOOD
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State | CA
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Zip | 90301-4502
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Country | US
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Telephone | 310-673-2647
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Fax |
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Provider Business Mailing Address
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Address Line | 918 HARTZELL ST
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City | PACIFIC PALISADES
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State | CA
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Zip | 90272-3818
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Country | US
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Telephone |
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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 | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number | RN436028
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | NMW727
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License Number State | CA
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