MEDICARE: FOX MORGAN BOSWELL MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	G36910	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467453910
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FOX MORGAN BOSWELL MD

Provider Business Mailing Address
First Line	:	4300 LONG BEACH BLVD
Second Line	:	STE 300
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2011
Country	:	US
Telephone Number	:	562-984-7024
Fax Number	:	562-428-7394

Provider Business Practice Location Address
First Line	:	4300 LONG BEACH BLVD
Second Line	:	STE 300
City	:	LONG BEACH
State	:	CA
Zip	:	90807-2011
Country	:	US
Telephone Number	:	562-984-7024
Fax Number	:	562-428-7394

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	07/08/2007

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