Individual
MR. ROBERT DAVID BOARDMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
726 4TH ST, MARYSVILLE, CA 95901-5656
(530) 749-4300
Mailing address
171 TALMONT CIR, ROSEVILLE, CA 95678-6059
(916) 666-8315
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
4704179940
MI
367500000X
Certified Registered Nurse Anesthetist
Primary
NA4354
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1013013481
MEDI-CAL
CA
05
—
102971314
—
MI
Enumeration date
06/23/2006
Last updated
01/03/2022
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