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General NPI Number Information
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NPI Number | 1245391242
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Entity Type | Individual
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Provider Name | SARAH GALADRIEL BOLES M.D.
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Gender | Female
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 06/02/2020
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Provider Practice Location Address
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Address Line | 3855 HEALTH SCIENCES DR 0987
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City | LA JOLLA
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State | CA
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Zip | 92093-0987
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Country | US
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Telephone | 858-822-6195
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Fax | 858-822-6196
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Provider Business Mailing Address
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Address Line | PO BOX 232410
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City | SAN DIEGO
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State | CA
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Zip | 92193-2410
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Country | US
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Telephone | 858-249-6749
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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 | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | A82562
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License Number State | CA
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