Individual
MR. BOB BYRON BOECKMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1940 MAPLE AVE, B3, COSTA MESA, CA 92627-5573
(171) 454-3543
Mailing address
1940 MAPLE AVE, B3, COSTA MESA, CA 92627-5573
(171) 454-3543
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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