Provider Demographics
NPI:1154331502
Name:BOGASH, JAMES A (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:BOGASH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1830 S ALMA SCHOOL RD STE 135
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85210-3088
Mailing Address - Country:US
Mailing Address - Phone:480-839-2273
Mailing Address - Fax:480-838-5474
Practice Address - Street 1:1830 S ALMA SCHOOL RD STE 135
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85210-3088
Practice Address - Country:US
Practice Address - Phone:480-839-2273
Practice Address - Fax:480-838-5474
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAZ5793111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor