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NPI Code Detail

MEDICARE: DR. CHARLES BOOKOFF MD

MEDICARE: DR. CHARLES BOOKOFF 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
1207V00000XObstetrics & Gynecology PhysicianG21934CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1G21934OTHERCACA LICENSE NUMBER
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1982664496
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES BOOKOFF MD
Provider Business Mailing Address
First Line : 9 COMMERCIAL BLVD 103
Second Line :
City : NOVATO
State : CA
Zip : 94949-6118
Country : US
Telephone Number : 415-448-1500
Fax Number : 415-798-3180
Provider Business Practice Location Address
First Line : 3260 KERNER BLVD
Second Line :
City : SAN RAFAEL
State : CA
Zip : 94901-4861
Country : US
Telephone Number : 415-499-6890
Fax Number : 415-499-4213
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/27/2006
Last Update Date : 11/09/2015

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