Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | G62299 | CA |
NPI | 1013091081 |
---|---|
Provider Name | Barbara Ann Boylan |
First Address | Healdsburg, CA 95448-3314 |
Second Address | Healdsburg, CA 95448-3314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 09/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G622990 | (05) | CA |
F15629 | (02) |