Mr Dwight Boochie, is a
Licensed Practical Nurse based in Lynwood, California. Mr Dwight Boochie is licensed to practice in California (license number VN 161753) and his current practice location is
2640 Industry Way, Lynwood, California. He can be reached at his office (for appointments etc.) via phone at
(310) 639-5983.
NPI number for Mr Dwight Boochie is 1649304213 and his current mailing address is 2640 Industry Way, Lynwood, California. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1649304213.
Provider's Profile
| Full Name | Mr Dwight Boochie |
|---|
| Gender | Male |
|---|
| Speciality | Licensed Practical Nurse |
|---|
| Location | 2640 Industry Way, Lynwood, California |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
|---|
NPI Data:
- NPI Number: 1649304213
- Provider Enumeration Date: 03/15/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mr Dwight Boochie such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1649304213 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | VN 161753 (California) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Dwight Boochie is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mr Dwight Boochie,
2640 Industry Way,
Lynwood, CA 90262-4000
Ph: (310) 639-5983 | Mr Dwight Boochie,
2640 Industry Way,
Lynwood, CA 90262-4000
Ph: (310) 639-5983 |
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