Bobo Primary Care Pc | |
304 Se Hearthwood Blvd # 873933 Vancouver WA 98684-7551 | |
(702) 849-3302 | |
Not Available |
Full Name | Bobo Primary Care Pc |
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Speciality | Internal Medicine |
Location | 304 Se Hearthwood Blvd # 873933, Vancouver, Washington |
Authorized Official Name and Position | Meskelo Bobo (OWNER) |
Authorized Official Contact | 7028493302 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Bobo Primary Care Pc 5870 W Harmon Ave Apt 257 Las Vegas NV 89103-4895 Ph: (720) 460-1501 | Bobo Primary Care Pc 304 Se Hearthwood Blvd # 873933 Vancouver WA 98684-7551 Ph: (702) 849-3302 |
NPI Number | 1306475181 |
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Provider Enumeration Date | 04/03/2020 |
Last Update Date | 10/11/2022 |
Medicare PECOS PAC ID | 8325469992 |
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Medicare Enrollment ID | O20241009001404 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306475181 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
Provider Name | Bona Bobo |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1659933075 PECOS PAC ID: 6507292851 Enrollment ID: I20230908002956 |
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