MEDICARE: BOYER B. COLE, N.D., NATUROPATHIC MEDICAL DOCTOR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2300X	Primary Care Clinic/Center	ND-63	CA

General Provider Information

NPI Number	:	1144488610
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BOYER B. COLE, N.D., NATUROPATHIC MEDICAL DOCTOR

Provider Business Mailing Address
First Line	:	25A SAN ANSELMO AVE
Second Line	:
City	:	SAN ANSELMO
State	:	CA
Zip	:	94960-2842
Country	:	US
Telephone Number	:	415-721-7453
Fax Number	:	415-721-7454

Provider Business Practice Location Address
First Line	:	25 SAN ANSELMO AVE STE A
Second Line	:
City	:	SAN ANSELMO
State	:	CA
Zip	:	94960-2842
Country	:	US
Telephone Number	:	415-721-7453
Fax Number	:	415-721-7454

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. BOYER BURTON COLE
Credential	:	N.M.D
Telephone Number	:	415-721-7453

Provider Enumeration Date	:	05/30/2008
Last Update Date	:	05/30/2008

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