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General NPI Number Information
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NPI Number | 1003497710
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Entity Type | Individual
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Provider Name | ALEXANDER BOYARKO
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Gender | Male
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Dates
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Enumeration Date | 04/15/2021
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Last Update Date | 07/16/2025
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Provider Practice Location Address
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Address Line | 11980 WALNUT LN APT 18
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City | LOS ANGELES
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State | CA
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Zip | 90025-3836
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Country | US
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Telephone | 303-437-5230
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Fax |
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Provider Business Mailing Address
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Address Line | 757 WESTWOOD PLZ
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City | LOS ANGELES
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State | CA
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Zip | 90095-8358
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Country | US
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Telephone | 310-825-9111
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A191293
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License Number State | CA
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