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Oklahoma Board of Medical Licensure and Supervision

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BOMBACH, ROGELIO       
This verification service provides current data extracted by the Oklahoma State Board of Medical Licensure and Supervision (OSBMLS) from its own database. The data enclosed in the green box below is provided by and controlled entirely by the OSBMLS and therefore constitutes a primary source verification of licensure status as authentic as a direct inquiry to the OSBMLS. NPI# and hospital privileges (if any) are provided by the licensee and not verified.
Practice Address: 7 NORTH ELLIS
PO BOX 1118
BOISE CITY OK 73933

Address last updated on 6/29/2017
Phone #: (580) 544-2534
Fax #:
County: CIMARRON
License: 12832
Dated: 8/7/1980
Expires: 8/20/2017
License Type: Medical Doctor
Specialty: Family Medicine
Pediatrics
Status: Inactive
Status Class: Deceased
Restricted to:
Registered to Dispense: YES
Medical School: Univ Auto De Guadalajara, Fac De Med, Guadalajara, Jalisco, Mexico
Graduated: 6 / 1976
CME Year: 2018
Pending and/or Past Disciplinary Actions:
Date Action Reasons Remarks
3/5/2010 Complaint Citation
#1/1/1900# Past Disciplinary Action
#1/1/1900# Past Disciplinary Action
Board Filings and/or Orders:
11/04/2010
09/16/2010
05/20/2010
02/12/2010
02/12/2010
All information below is entered by the licensee but not verified by the Oklahoma Medical Board.
Certifications:
New Patients: No
Medicaid: No
Medicare: No
   
HMO/PPO: Aetna HMO
Aetna PPO
Blue Cross Blue Shield-Blue Preferred
Blue Cross Blue Shield-Blue Traditional
Blue Cross Blue Shield-Plan 65 Select
BlueChoice PPO
BlueLincs HMO
Champ VA
CIGNA PPO
CommunityCare HMO, Inc
Coventry Health Care National Network
First Health
HealthChoice
Humana Medicare Advantage PPO
Humana Tricare/PGBA
PacifiCare of Oklahoma, Inc
Preferred Community Choice
Prudential Health Care Plan, Inc
Railroad Medicare
SoonerCare HMO
SoonerCare PPO
Tricare for Life
Tricare Standard
United Healthcare Choice
United Healthcare EPO
United Healthcare HMO
United Healthcare Options PPO
United Healthcare POS
Hospital Privileges: None listed
Locations: Hours: Languages:
7 NORTH ELLIS
PO BOX 1118
BOISE CITY OK 73933

Phone #: (580) 544-2534
Fax #:
Spanish

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