Organization
BRIAN J W BOYD M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN JW BOYD M.D. (OWNER)
(714) 285-0615
Entity
Organization
Contact information
Practice address
1140 W LA VETA AVE STE 410, ORANGE, CA 92868-4226
(714) 285-0615
(714) 285-0619
Mailing address
1140 W LA VETA AVE STE 410, ORANGE, CA 92868-4226
(714) 285-0615
(714) 285-0619
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
G59654
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1932242302
IND-NPI
CA
01
—
G59654
STATE LICENSE
CA
Enumeration date
09/07/2010
Last updated
09/07/2010
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