Provider Demographics
NPI:1538250808
Name:BOKEN, DANIEL JAMES (MD)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:JAMES
Last Name:BOKEN
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:PO BOX 767
Mailing Address - Street 2:
Mailing Address - City:VISALIA
Mailing Address - State:CA
Mailing Address - Zip Code:93279-0767
Mailing Address - Country:US
Mailing Address - Phone:559-624-2735
Mailing Address - Fax:559-627-4505
Practice Address - Street 1:116 N AKERS ST
Practice Address - Street 2:
Practice Address - City:VISALIA
Practice Address - State:CA
Practice Address - Zip Code:93291-5121
Practice Address - Country:US
Practice Address - Phone:559-624-2735
Practice Address - Fax:559-627-4505
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2007-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG86899207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA18152Medicare PIN
CAF52916Medicare UPIN