Individual
RICHARD GREGORY BOLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4650 W SUNSET BLVD, MS# 90, LOS ANGELES, CA 90027-6062
(323) 361-2178
(323) 361-5937
Mailing address
6430 W SUNSET BLVD, SUITE 600, LOS ANGELES, CA 90028-7901
(323) 361-2337
(323) 361-8491
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
G65717
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G657170 G79
CAL OPTIMA
CA
05
—
00G6571710
—
CA
Enumeration date
09/29/2006
Last updated
05/14/2008
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