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General NPI Number Information
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NPI Number | 1871591727
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Entity Type | Individual
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Provider Name | WAYNE RODNEY BOYD MD
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Gender | Male
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Dates
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Enumeration Date | 07/13/2005
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Last Update Date | 01/15/2018
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Provider Practice Location Address
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Address Line | 399 E 21ST ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-4815
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Country | US
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Telephone | 909-882-2266
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Fax | 909-881-7593
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Provider Business Mailing Address
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Address Line | 399 E 21ST ST
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City | SAN BERNARDINO
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State | CA
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Zip | 92404-4815
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Country | US
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Telephone | 909-882-2266
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Fax | 909-881-7593
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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 | A21591
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License Number State | CA
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