Healthcare Provider Details

I. General information

NPI: 1992960462
Provider Name (Legal Business Name): DARREN MICHAEL BOYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/24/2008
Last Update Date: 01/02/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 SANTA MONICA BLVD STE 490W
SANTA MONICA CA
90404-2127
US

IV. Provider business mailing address

2001 SANTA MONICA BLVD STE 490W
SANTA MONICA CA
90404-2127
US

V. Phone/Fax

Practice location:
  • Phone: 310-359-6790
  • Fax: 800-844-5249
Mailing address:
  • Phone: 310-359-6790
  • Fax: 844-800-5249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License NumberA111784
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: