Individual
DR. CHARLES BOADU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4445 MAGNOLIA AVE, RIVERSIDE, CA 92501-4135
(951) 788-3000
Mailing address
5134 BALLANTRAE BLVD, LAND O LAKES, FL 34638-3065
(718) 791-6887
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
ME152416
FL
207RC0000X
Cardiovascular Disease Physician
ME152416
FL
208D00000X
General Practice Physician
Primary
200762
CA
208D00000X
General Practice Physician
ME152416
FL
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
FL
01
—
WX786
HFMG
FL
Enumeration date
04/26/2019
Last updated
02/03/2026
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