MEDICARE: SARAH ELIZABETH BOYER

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	3747A0650X	Attendant Care Provider

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	WDL1763JC93B	OTHER	WA	DRIVER LICENSE

General Provider Information

NPI Number	:	1689470114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH ELIZABETH BOYER

Provider Business Mailing Address
First Line	:	9650 MARILLA DR APT 79
Second Line	:
City	:	LAKESIDE
State	:	CA
Zip	:	92040-2850
Country	:	US
Telephone Number	:	619-823-3369
Fax Number	:

Provider Business Practice Location Address
First Line	:	2178 VALLEY LAKE DR
Second Line	:
City	:	EL CAJON
State	:	CA
Zip	:	92020-1031
Country	:	US
Telephone Number	:	619-823-3369
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/24/2025
Last Update Date	:	02/24/2025

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