Provider Demographics
NPI:1174504013
Name:BOSE, ALOK K (MD)
Entity Type:Individual
Prefix:DR
First Name:ALOK
Middle Name:K
Last Name:BOSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:118 SAGE WAY
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-3574
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5030 BUSINESS CENTER DR
Practice Address - Street 2:SUITE 230
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94534-6874
Practice Address - Country:US
Practice Address - Phone:707-863-8190
Practice Address - Fax:707-863-8193
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-08
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA809912080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric Cardiology