Provider Demographics
NPI:1134316870
Name:BOGOIAN, RONALD DAN (DPM)
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:DAN
Last Name:BOGOIAN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:255 MARCH ST
Mailing Address - Street 2:
Mailing Address - City:SANTA PAULA
Mailing Address - State:CA
Mailing Address - Zip Code:93060-2511
Mailing Address - Country:US
Mailing Address - Phone:805-525-5415
Mailing Address - Fax:805-525-0448
Practice Address - Street 1:255 MARCH ST
Practice Address - Street 2:
Practice Address - City:SANTA PAULA
Practice Address - State:CA
Practice Address - Zip Code:93060-2511
Practice Address - Country:US
Practice Address - Phone:805-525-5415
Practice Address - Fax:805-525-0448
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2012-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4714213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery