Healthcare Provider Details

I. General information

NPI: 1750438511
Provider Name (Legal Business Name): BOYD & GARCIA MEDICAL GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1140 W LA VETA AVE SUITE 410
ORANGE CA
92868-4223
US

IV. Provider business mailing address

1140 W LA VETA AVE SUITE 410
ORANGE CA
92868-4223
US

V. Phone/Fax

Practice location:
  • Phone: 714-547-8700
  • Fax:
Mailing address:
  • Phone: 714-547-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberG59399
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License NumberG71922
License Number StateCA

VIII. Authorized Official

Name: DR. LILLY FRANCINE RAMIREZ-BOYD
Title or Position: OWNER
Credential: M.D.
Phone: 714-633-4463