National Provider Identifier Database

FRED C BOBOTH, O.D., P.S. – NPI #1194879700
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

FRED C BOBOTH, O.D., P.S.
403 N EUCLID RD
GRANDVIEW, WA98930-9407
Phone: 509-882-2650
Fax: 509-882-4225
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X

* Indicates primary specialty

NPI Profile & details for FRED C BOBOTH

NPI Number 1194879700
Credentials O.D., P.S.
Entity Individual
Enumeration date 01/22/2007
Last updated 04/10/2013 - About 13 years ago
Sole proprietor1 Yes
Identifiers
  • WA License #: 1634TX
  • WA Medicaid: 2021554
  • WA Other: BO4392 BLUE CROSS BLUE SHIELD NO
  • WA Other: G8902905 CHAMPUS ID NO REGION WEST
  • WA Other: 0317360001 DME REGION D SUPPLIER NO
  • WA Other: 911936651 GROUP HEALTH NORTHWEST
  • WA Other: 71549 LABOR AND INDUSTRIES
  • WA Other: 010062119 MEDICARE RAILROAD
  • WA Other: 911936651 PREMERA BLUE CROSS
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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