Individual provider Active NPI

John Roderick Ten Bosch, PHD

  • Clinical Molecular Genetics Physician
  • San Jose, CA
National Provider Identifier
1609211390
Registry record updated May 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Molecular Genetics PhysicianTaxonomy code 207SG0203X
License
DRN64 Issued in CA
Practice address
5755 Cottle Rd BLDG 6
San Jose, CA 95123-3640
Phone
(408) 972-6752
NPI assigned
May 8, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Cytogenetics Physician 207SC0300X MTO653 CA
Clinical Molecular Genetics Physician 207SG0203X DRN64 CA Primary

Addresses

Primary practice location

5755 Cottle Rd BLDG 6
San Jose, CA 95123-3640

Mailing address

5755 Cottle Rd BLDG 6
San Jose, CA 95123-3640

Other identifiers 3

IdentifierTypeStateIssuer
DRN64OtherCACALIFORNIA DEPARTMENT OF PUBLIC HEALTH - LAB FIELD SERVICES
2009152OtherCAAMERICAN BOARD OF MEDICAL GENETICS
MTO653OtherCACALIFORNIA DEPARTMENT OF PUBLIC HEALTH - LAB FIELD SERVICES

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
MTO653CAMDClinical Cytogenetics Physician
DRN64CAMDClinical Molecular Genetics Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1367971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1367971200000",
    "number": "1609211390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5755 COTTLE RD BLDG 6",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5755 COTTLE RD BLDG 6",
            "city": "SAN JOSE",
            "state": "CA",
            "postal_code": "951233640",
            "telephone_number": "408-972-6752"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TEN BOSCH",
        "first_name": "JOHN",
        "middle_name": "RODERICK",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-05-08",
        "last_updated": "2013-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207SC0300X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Cytogenetics",
            "state": "CA",
            "license": "MTO653",
            "primary": false
        },
        {
            "code": "207SG0203X",
            "taxonomy_group": "",
            "desc": "Medical Genetics, Clinical Molecular Genetics",
            "state": "CA",
            "license": "DRN64",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DEPARTMENT OF PUBLIC HEALTH - LAB FIELD SERVICES",
            "identifier": "DRN64",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN BOARD OF MEDICAL GENETICS",
            "identifier": "2009152",
            "state": "CA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CALIFORNIA DEPARTMENT OF PUBLIC HEALTH - LAB FIELD SERVICES",
            "identifier": "MTO653",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Jose, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.