Anthony Corey Boganey, M.D.

Individual provider Active NPI Surgery Physician · Camp Pendleton, CA

NPI 1508842014 · NPPES record last updated Dec 17, 2013

Key facts

NPI
1508842014
Entity type
Individual (NPI type 1)
Primary specialty
Surgery Physician 208600000X
License
35.082233 (OH)
Practice address
Naval Hospital Camp Pendleton
Department of General Surgery
Camp Pendleton, CA 92055
Phone
(760) 725-1356
Fax
(760) 725-0117
NPI assigned
Dec 16, 2005
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 Medicine

State licenses

LicenseStateTypeSpecialty
35.082233OHMDSurgery Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 35.082233 OH Yes

Addresses

Primary practice location

Naval Hospital Camp Pendleton
Department of General Surgery
Camp Pendleton, CA 92055

Mailing address

11993 Briarleaf Way
San Diego, CA 92128-5229
Phone (858) 748-4109

Other providers in Camp Pendleton, CA

All providers in Camp Pendleton, CA · Surgery Physician in California

Sources for this page

Verify at the official NPI Registry.