John Patrick Bossalini, DO
Individual provider Active NPI General Practice Physician · Beale Afb, CA
NPI 1396247441 · NPPES record last updated Oct 18, 2019
Key facts
- NPI
- 1396247441
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Physician 208D00000X
- License
- 0102205749 (VA)
- Practice address
- 15301 Warren Shingle Rd
Beale Afb, CA 95903-1907 - Phone
- (530) 634-4730
- NPI assigned
- Mar 5, 2018
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Military Health Care Provider | 171000000X | 0102205749 | VA | |
| General Practice Physician | 208D00000X | 0102205749 | VA | Yes |
Addresses
Primary practice location
15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Mailing address
15301 Warren Shingle Rd
Beale Afb, CA 95903-1907
Other providers in Beale Afb, CA
- Timber Ann Best
- Evan Wesley Birchard
- Eileen Bird
- Emma Black
- Angelo J. Boss
- Joel Edward Brady
- Sadina Lynn Brecheisen-Beach
- Joshua Thomas Breding
- Cole Brennan
- Dennis William Bull
All providers in Beale Afb, CA · General Practice Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 18, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.