Individual
MR. MARC PATRICK BOULANGER II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP
Contact information
Practice address
200 W ARBOR DR, SAN DIEGO, CA 92103-9000
(800) 926-8273
(888) 539-8781
Mailing address
FILE 53726, LOS ANGELES, CA 90074-0001
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
95035464
CA
Other
Enumeration date
06/06/2025
Last updated
11/05/2025
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