Individual
DR. MIRANDA DIANE BOISCLAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
11301 WILSHIRE BLVD BLDG 500, LOS ANGELES, CA 90073-1003
(310) 362-0179
Mailing address
535 GAYLEY AVE APT 207, LOS ANGELES, CA 90024-2040
(843) 597-0429
Taxonomy
Speciality
Code
Description
License number
State
1835G0303X
Geriatric Pharmacist
Primary
011439
SC
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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