National Provider Identifier Database

BOSTON MEDICAL GROUP CALIFORNIA LLC
Urology

A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures.


Contact Information

BOSTON MEDICAL GROUP CALIFORNIA LLC
207 S SANTA ANITA AVE
P25A
SAN GABRIEL, CA91776
Phone: 615-562-4578
Fax: 423-949-3992
Website:
Specialty Taxonomy Code
* Urology 208800000X

* Indicates primary specialty

NPI Profile & details for BOSTON MEDICAL GROUP CALIFORNIA LLC

NPI Number 1851799001
Legal business name
LBN
BOSTON MEDICAL GROUP CALIFORNIA LLC
Authorized official JOAN SIMPSON - (DIRECTOR OF CQRM)
Entity Organization
Organization subpart No
Enumeration date 12/19/2014
Last updated 12/19/2014 - About 11 years ago
Sole proprietor1 Not specified
Identifiers
  • CA License #: G9455

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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