Mandava, Bose

Mandava, Bose is an sole proprietor health care provider with primary practice located at 825 North 10Th Street , Santa Paula CA 93060. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Mandava, Bose can be contacted via phone (805) 933-8600.

Contact Information

Primary practice address
825 North 10Th Street Santa Paula CA 93060
Phone: (805) 933-8600
Fax: (805) 933-8664
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X C5112 California
Allopathic & Osteopathic Physicians / Anesthesiology 207L00000X C51112 California

Profile Details

NPI number 1477609568
LBN Legal business name Mandava, Bose
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 25th, 2007
Last updated Aug 1st, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477609568 NPPES
California MEDICAID 00C511120

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