Individual
ROBERT BOSTONIAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
67 GRANDE PASEO, SAN RAFAEL, CA 94903-1555
(415) 535-5554
Mailing address
PO BOX 3517, SAN RAFAEL, CA 94912-3517
(415) 535-5554
Taxonomy
Speciality
Code
Description
License number
State
324500000X
Substance Abuse Rehabilitation Facility
Primary
122932
CA
Other
Enumeration date
09/17/2015
Last updated
09/17/2015
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