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General NPI Number Information
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NPI Number | 1841260452
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Entity Type | Individual
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Provider Name | CHRISTINE BOULANGER MD
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Gender | Female
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Dates
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Enumeration Date | 01/25/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 625 HILBY AVE
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City | SEASIDE
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State | CA
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Zip | 93955-5720
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Country | US
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Telephone | 831-394-1691
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Fax | 831-394-1870
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Provider Business Mailing Address
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Address Line | 1691 THE ALAMEDA
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City | SAN JOSE
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State | CA
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Zip | 95126-2203
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Country | US
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Telephone | 408-795-3619
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Fax | 408-287-0405
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 58266
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 51652
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License Number State | CA
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