Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 2018035929 | MO |
Y | 208000000X | Pediatrician | A172443 | CA |
N | 2080P0204X | Pediatric Emergency Doctor | 2018035929 | MO |
NPI | 1225489305 |
---|---|
Provider Name | Dr. Elizabeth Anne Bozaan Fox |
First Address | Saint Louis, MO 63110-1002 |
Second Address | Palo Alto, CA 94304-1601 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2016 |
Last Update Date | 08/10/2021 |