Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1396247441 Individual Practitioner Male Practitioner

Dr. John Patrick Bossalini , DO

General Practice • Beale Afb, CA

Professional Overview & Biography Verified Profile Summary

Dr. John Bossalini, DO is a registered healthcare professional specializing in General Practice in Beale Afb, CA. Practice services are available at 15301 WARREN SHINGLE RD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

15301 Warren Shingle Rd

Beale Afb, CA 959031907

Telephone 5306344730
Associated Practice Facility / Clinic
🏢 9th Medgrp-Beale Facility NPI 1184695991

Specialty Benchmarks & Practice Insights

Comparative analytics for General Practice in Beale Afb, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 31.1 Yrs
Regional Practice Density
4 Specialists

Practicing in Beale Afb, CA (2300 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

General Practice Primary Specialty

NUCC Taxonomy Code: 208D00000X

State License VA 0102205749

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.

Military Health Care Provider

NUCC Taxonomy Code: 171000000X

State License VA 0102205749

Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

4 Associated Practitioners
Dr. Ki-Hyeok Lee , MD

General Practice

NPI 1548250731

Doctor of Medicine (M.D.)

Tanisha Harrison

Military Health Care Provider - Independent Duty Medical Technicians

NPI 1750516530
Dr. Leonid Katkovsky , MD

Military Health Care Provider

NPI 1821087719

Doctor of Medicine (M.D.)

Michell Girton , IDMT

Military Health Care Provider - Independent Duty Medical Technicians

NPI 1851526057

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

16 Historical Events
📍
Updated Practice Location July 16, 2019

Registered at 15301 WARREN SHINGLE RD, BEALE AFB, CA 959031907 (Tel: 5306344730)

📍
Updated Business Mailing Address July 16, 2019

Registered at 15301 WARREN SHINGLE RD, BEALE AFB, CA 959031907

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 16, 2019

Military Health Care Provider (License #0102205749 in VA)

📍
Updated Practice Location August 22, 2018

Registered at 1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 78236 (Tel: 2102286264)

📍
Updated Practice Location August 13, 2018

Registered at 2200 BERGQUIST DR STE 1, JBSA LACKLAND, TX 78236 (Tel: 2109165545)

NPI Profile Active April 09, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location April 09, 2018

Registered at 1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 782365638 (Tel: 2109165545)

📍
Updated Business Mailing Address April 09, 2018

Registered at 1100 WILFORD HALL LOOP BLDG 4554, JBSA LACKLAND, TX 782365638

👤
Provider Name / Credentials Updated April 09, 2018

Recorded as JOHN BOSSALINI, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) April 09, 2018

Student in an Organized Health Care Education/Training Program

NPI Profile Active March 05, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location March 05, 2018

Registered at 2200 BERGQUIST DR STE 1, JBSA LACKLAND, TX 782369908 (Tel: 5188320200)

📍
Updated Business Mailing Address March 05, 2018

Registered at 2200 BERGQUIST DR STE 1, JBSA LACKLAND, TX 782369908

👤
Provider Name / Credentials Updated March 05, 2018

Recorded as JOHN BOSSALINI, DO

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 05, 2018

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 05, 2018

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1396247441
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 05, 2018
Last Update: October 18, 2019
Sole Proprietor: No

Mailing Address

15301 Warren Shingle Rd

Beale Afb, CA 959031907

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.