Laurence Boggeln (NPI# 1992701080, PAC ID# 6800809740) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1992701080 |
| PAC ID by PECOS | 6800809740 |
| Professional Enrollment ID | I20070518000296 |
| Full Name | Laurence Boggeln |
| Organization Legal Name | ELIZABETH SUPPORTIVE MEDICAL SPECIALISTS, A MEDICAL CORPORATION |
| Address |
27720 Jefferson Ave Suite 200 Temecula CA 92590-2630 |
| Phone Number | 7607963758 |
| Gender | M |
| Credential | MD |
| Medical School | SAINT LOUIS UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1980 |
| Primary Specialty | FAMILY MEDICINE |
| Secondary Specialties | HOSPICE/PALLIATIVE CARE |
| Group Practice PAC ID | 3971880055 |
| Number of Group Practice Members | 6 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 050775 | TEMECULA VALLEY HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 27720 Jefferson Ave, Suite 200, Temecula, CA 92590-2630 | 7607963758 | ELIZABETH SUPPORTIVE MEDICAL SPECIALISTS, A MEDICAL CORPORATION |
| Organization Legal Name | ELIZABETH SUPPORTIVE MEDICAL SPECIALISTS, A MEDICAL CORPORATION |
| Physicians | 5 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Glenn M Panzer | Hospice/palliative Care | Elizabeth Supportive Medical Specialists, A Medical Corporation | 500 La Terraza Blvd, Suite 320, Escondido, CA 92025-3875 |
| Shannon Marie Bagnasco | Nurse Practitioner | Elizabeth Supportive Medical Specialists, A Medical Corporation | 500 La Terraza Blvd, Suite 320, Escondido, CA 92025-3875 |
| Eric Michael Emont | Geriatric Medicine | Elizabeth Supportive Medical Specialists, A Medical Corporation | 500 La Terraza Blvd, Suite 320, Escondido, CA 92025-3875 |
| Joann M Adams | Nurse Practitioner | Elizabeth Supportive Medical Specialists, A Medical Corporation | 500 La Terraza Blvd, Suite 320, Escondido, CA 92025-3875 |
| Street Address |
27720 JEFFERSON AVE SUITE 200 |
| City | TEMECULA |
| State | CA |
| Zip | 92590-2630 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Humberto S Aragon | General Practice | 27625 Jefferson Ave, Suite 101, Temecula, CA 92590-2619 | |
| Gerardo W Hizon | Family Medicine | 27699 Jefferson Ave, Suite 101, Temecula, CA 92590-2696 | |
| Ricardo R Vega | Pulmonary Disease | 27699 Jefferson Ave, Suite 204, Temecula, CA 92590-2696 | |
| Matthew S Gargulinski | Orthopedic Surgery | James J Chao Md Facs | 27699 Jefferson Ave, Suite 201, Temecula, CA 92590-2697 |
| Emily Sue Mason | Physical Therapy | All Star Physical Therapy Inc | 27699 Jefferson Ave, Suite 202, Temecula, CA 92590-2697 |
| Ernesto T Salas | Internal Medicine | 27699 Jefferson Ave, Suite 311, Temecula, CA 92590-2697 | |
| Shaun D Young | Physician Assistant | James J Chao Md Facs | 27699 Jefferson Ave, Suite 201, Temecula, CA 92590-2697 |
| John R Feeney | Family Practice | Tvfm, Inc | 28999 Old Town Front St, Suite 104, Temecula, CA 92590-2842 |
| Kameko Ann Howells | Clinical Social Worker | 28924 Old Town Front St, Temecula, CA 92590-2857 | |
| John A Huette | General Practice | Healthpointe Medical Group, Inc. | 28991 Old Town Front St, Suite 104, Temecula, CA 92590-2858 |
| Find all physicians in zip 92590 | |||
| City | TEMECULA |
| Zip Code | 92590 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | TEMECULA + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Laurence Boggeln.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.