Provider Demographics
NPI:1851657936
Name:BOCO, ERWIN VICTOR SALVADOR (MD)
Entity Type:Individual
Prefix:DR
First Name:ERWIN
Middle Name:VICTOR SALVADOR
Last Name:BOCO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:311 WEST I SRREET
Mailing Address - Street 2:
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-3479
Mailing Address - Country:US
Mailing Address - Phone:209-826-2222
Mailing Address - Fax:209-826-0199
Practice Address - Street 1:311 W I ST
Practice Address - Street 2:
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635-3479
Practice Address - Country:US
Practice Address - Phone:209-826-2222
Practice Address - Fax:209-826-0199
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA120032208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice