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General NPI Number Information
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NPI Number | 1366249179
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Entity Type | Organization
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Legal Business Name | MICHAEL W DEBOISBLANC MD INC
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Dates
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Enumeration Date | 02/27/2025
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 2637 SHADELANDS DR
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City | WALNUT CREEK
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State | CA
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Zip | 94598-2512
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Country | US
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Telephone | 925-932-6330
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Fax |
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Provider Business Mailing Address
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Address Line | 2419 CUTTING ST
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City | WALNUT CREEK
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State | CA
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Zip | 94596-6507
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Country | US
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Telephone | 925-360-8836
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL WILLIAM DEBOISBLANC
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Credential | MD
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Telephone | 925-360-8836
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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