Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | DC17627 | CA |
NPI | 1780810770 |
---|---|
Provider Name | Dr. John Joseph Boyko |
First Address | Fullerton, CA 92832-1621 |
Second Address | Fullerton, CA 92832-1621 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2009 |
Last Update Date | 03/06/2009 |