Healthcare Provider Details
I. General information
NPI: 1952462947
Provider Name (Legal Business Name): JAMES LESLIE BOYD JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
605 ASCADA CT
FOLSOM CA
95630-4916
US
IV. Provider business mailing address
605 ASCADA CT
FOLSOM CA
95630-4916
US
V. Phone/Fax
- Phone: 530-913-9632
- Fax:
- Phone: 530-913-9632
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | G22310 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208100000X |
| Taxonomy | Physical Medicine & Rehabilitation Physician |
| License Number | G22310 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: