Richard C. Boise
Adolescent Medicine
3400 Delta Fair Blvd
Antioch
, California 94509-4004
Richard C. Boise
Adolescent Medicine
3400 Delta Fair Blvd
Antioch
, California 94509-4004
(510) 625-6262
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About
Features
Specialties
- Adolescent Medicine
Languages spoken
- English
Location
First Address
- Richard C. Boise
- 1800 Harrison St Fl 7
- Oakland, CA
- Zip : 94612-3429
- Phone : (510) 625-6262
Second Address
- Richard C. Boise
- 3400 Delta Fair Blvd
- Antioch, CA
- Zip : 94509-4004
- Phone : (925) 779-5000
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 2080A0000X | Adolescent Medicine | G36281 | CA |
National Provider Identifier
| NPI | 1255483483 |
|---|---|
| Provider Name | Richard C. Boise |
| First Address | Oakland, CA 94612-3429 |
| Second Address | Antioch, CA 94509-4004 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 17/01/2007 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 00G362810 | (05) | CA |
| F10888 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.