BOZUK & ASSOCIATES SURGICAL, INC. (NPI# 1609912914) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609912914 |
| Entity Type | Organization |
| Organization Name | BOZUK & ASSOCIATES SURGICAL, INC. |
| Practice Address |
1456 Professional Dr Ste. #404 Petaluma CA 94954-6639 |
| Practice Telephone | 7077633967 |
| Practice Fax Number | 7077650554 |
| Mailing Telephone | 7077633967 |
| Mailing Fax Number | 7077650554 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. MICHAEL IVAN BOZUK (PHYSICIAN) |
| Authorized Official Telephone | 7077633967 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208600000X | Surgery | A73703 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | 00A737030 | 05 |
| Street Address |
1456 PROFESSIONAL DR STE. #404 |
| City | PETALUMA |
| State | CA |
| Zip Code | 94954-6639 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265432454 | Klaus J Radtke | Dentist | 1456 Professional Dr, Suite # 401, Petaluma, CA 94954-6639 | 2005-07-28 |
| 1245446780 | Richard Eugene Altieri Perez | Surgery | 1456 Professional Dr, Suite #404, Petaluma, CA 94954-6639 | 2007-05-14 |
| 1952411043 | Paula Renee Gardner | Dentist | 1456 Professional Dr, Ste 401, Petaluma, CA 94954-6639 | 2006-08-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346883840 | Miguel Ibarra | Counselor | 5350 Old Redwood Highway, Petaluma, CA 94954 | 2019-10-28 |
| 1073169223 | Monica Renee Najera | Behavior Technician | 1670 Corporate Circle, Ste. 100, Petaluma, CA 94954 | 2019-08-14 |
| 1326607201 | Making Magic Happen - People Helping People, Inc. | Marriage & Family Therapist | 1318 Redwood Way, Suite 260, Petaluma, CA 94954 | 2019-06-13 |
| 1477019917 | Rubi Isela Cruz Mendoza I | Behavioral Analyst | 8 Round Walk Circle, Petaluma, CA 94954 | 2019-02-20 |
| 1932679511 | Karen Christianson | Behavior Technician | 1670 Corporate Circle Suite 100, Petaluma, CA 94954 | 2018-11-27 |
| 1669956967 | Alyssa Messer | Assistant Behavior Analyst | 1670 Corporate Cir, Petaluma, CA 94954 | 2018-09-21 |
| 1235620592 | Mallory Paige Mullikin | Nurse Practitioner | 141 Lynch Creek Trail, Ste C, Petaluma, CA 94954 | 2018-05-22 |
| 1457723710 | Lisabel Dolne | Counselor | 1360 N. Mcdowell Blvd.1a, Petaluma, CA 94954 | 2015-10-27 |
| 1083080717 | Pacific Restorative Center | Clinic/Center | 1456 Professional Drive, Suite 404, Petaluma, CA 94954 | 2015-08-17 |
| 1619354198 | Accu Quest Hearing Centers | Clinic/Center | 1456 Professional Dr., Suite 404, Petaluma, CA 94954 | 2015-05-04 |
| Find all providers in zip 94954 | ||||
| Taxonomy Code | 208600000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316907082 | Peter Vincent Leoni | Surgery | 1116 B St, Petaluma, CA 94952-4054 | 2006-03-25 |
| 1912355397 | Russell W. Sawyer, M.d. Professional Corporation | Surgery | 141 Lynch Creek Way, Suite A, Petaluma, CA 94954-2341 | 2016-05-26 |
| 1245446780 | Richard Eugene Altieri Perez | Surgery | 1456 Professional Dr, Suite #404, Petaluma, CA 94954-6639 | 2007-05-14 |
| 1063524528 | Elpidio C Mariano | Surgery | 106 Lynch Creek Way, Suite 9b, Petaluma, CA 94954-2356 | 2006-08-31 |
| 1700998259 | Cesar P Veluz | Surgery | 106 Lynch Creek Way, Suite 9b, Petaluma, CA 94954-2356 | 2006-08-31 |
| 1700800604 | Michael I Bozuk | Surgery | 3835 Cypress Dr, Ste 202, Petaluma, CA 94954-6965 | 2006-07-26 |
| 1851338537 | Keith F. Korver, M.d., Inc. | Surgery | 719 Southpoint Blvd, Ste B, Petaluma, CA 94954-8003 | 2006-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344321 | Sadeghi Medical Corporation | Surgery | 3871 Piedmont Ave # 105, Oakland, CA 94611-5378 | 2020-10-21 |
| 1295332823 | Vneo Medical Clinic Inc | Surgery | 6817 1/2 Kester Ave, Van Nuys, CA 91405-3716 | 2020-10-06 |
| 1619584497 | Prohealth Partners A Medical Group | Surgery | 3628 E Imperial Hwy Ste 303, Lynwood, CA 90262-2646 | 2020-09-25 |
| 1235744004 | Yvette Speight Md Inc | Surgery | 433 N Doheny Dr, Beverly Hills, CA 90210-5734 | 2020-09-09 |
| 1538786900 | Tdwo Inc | Surgery | 57445 29 Palms Hwy Ste 301, Yucca Valley, CA 92284-2947 | 2020-07-01 |
| 1003439746 | Howard Takiff | Surgery | 760 La Canada St, La Jolla, CA 92037-6724 | 2020-05-27 |
| 1629698253 | Gisela Regalado Paredes | Surgery | Antelope Valley Hospital, 1600 West Ave J, Lancaster, CA 93534 | 2020-04-23 |
| 1811517667 | John K Colwell | Surgery | 222 Hollywood Ave, Los Gatos, CA 95030 | 2020-04-22 |
| 1295361772 | William Robert Berry | Surgery | 5775 Del Cerro Blvd, San Diego, CA 92120-4513 | 2020-03-17 |
| 1497380638 | Bay Area Medical and Surgical Group, Inc. | Surgery | 490 Post St Ste 530, San Francisco, CA 94102-1412 | 2020-03-09 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.