Doctor Name: | MICHAEL GORDON BOGDANOFF |
NPI Number: | 1023357134 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | SLP MA JD |
License Number: | SP13234 |
Business Practice Address: | 6000 Santa Rosa Rd Camarillo, CA - 930127101 |
Business Phone Number: | 8053888086 |
Business Fax Number: | 8053836700 |
Mailing Address: | 2222 Sulllivan Trail, EASTON |
State: | PA |
Postal Code: | 180407958 |
Phone Number: | 8009449782 |
Fax Number: | 6104382046 |
NPI Enumeration Date: | 02/08/2013 |
NPI Last Update Date: | 02/08/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | SP13234 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |