Provider Demographics
NPI:1508842014
Name:BOGANEY, ANTHONY COREY (MD)
Entity Type:Individual
Prefix:DR
First Name:ANTHONY
Middle Name:COREY
Last Name:BOGANEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11993 BRIARLEAF WAY
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92128-5229
Mailing Address - Country:US
Mailing Address - Phone:858-748-4109
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL CAMP PENDLETON
Practice Address - Street 2:DEPARTMENT OF GENERAL SURGERY
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-725-1356
Practice Address - Fax:760-725-0117
Is Sole Proprietor?:No
Enumeration Date:2005-12-16
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.082233208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery