Healthcare Provider Details

I. General information

NPI: 1689014318
Provider Name (Legal Business Name): STEPHEN ALLEN BOYKINS DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/26/2013
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11411 BROOKSHIRE AVE STE 501
DOWNEY CA
90241-5007
US

IV. Provider business mailing address

596 VERMONT ST APT 2F
BROOKLYN NY
11207-5810
US

V. Phone/Fax

Practice location:
  • Phone: 562-651-1050
  • Fax: 562-868-2828
Mailing address:
  • Phone: 954-734-0713
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code211D00000X
TaxonomyPodiatric Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: