Individual
DR. CHARLES ANTHONY BOUDREAUX
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3315 WATT AVE, SACRAMENTO, CA 95821-3600
(916) 481-6800
(916) 481-1881
Mailing address
PO BOX 660910, SACRAMENTO, CA 95866-0910
(916) 481-6800
(916) 481-1881
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G76780
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0028370
—
CA
Enumeration date
08/31/2005
Last updated
11/19/2010
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