Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | G63507 | CA |
NPI | 1023082393 |
---|---|
Provider Name | John B Bosetti |
First Address | Napa, CA 94558-3044 |
Second Address | Napa, CA 94558-3044 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2006 |
Last Update Date | 01/02/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E74530 | (02) | CA |