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EDWARD BOCC PHYSICIAN ASSISTANT

>> Physician Assistant >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1215014469

Individual Registrant:
 EDWARD  BOCC PHYSICIAN ASSISTANT
Gender: M
Not Sole Proprietor

Location and contact information for practice:
1381 UNIVERSITY AVE  HEALDSBURG, CA 95448-3314 US
Tel: 707-431-8234  Fax: 707-431-8649

Contact information for business:
1381 UNIVERSITY AVE  HEALDSBURG, CA 95448 US
Tel: 707-431-8234  Fax: --

Registration Information:
NPI: 1215014469
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363A00000XPhysician Assistants & Advanced Practice Nursing Providers
Physician Assistant
CAPA18351

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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