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General NPI Number Information
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NPI Number | 1346309234
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Entity Type | Individual
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Provider Name | RICHARD B BOYLE O.D.
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Gender | Male
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Dates
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Enumeration Date | 12/06/2006
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Last Update Date | 05/23/2008
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Provider Practice Location Address
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Address Line | 1390 N MCDOWELL BLVD STE F
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City | PETALUMA
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State | CA
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Zip | 94954-7104
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Country | US
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Telephone | 707-795-7433
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Fax | 707-795-7359
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Provider Business Mailing Address
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Address Line | 1390 N MCDOWELL BLVD STE F
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City | PETALUMA
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State | CA
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Zip | 94954-7104
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Country | US
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Telephone | 707-795-7433
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Fax | 707-795-7359
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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 | 152WC0802X
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Taxonomy Name | Corneal and Contact Management Optometrist
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License Number | 5820T
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License Number State | CA
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