MEDICARE: DR. JAMES E BOYD MD

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	207Q00000X	Family Medicine Physician	A75335	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	FHC11992H	OTHER		MEDI-CAL

General Provider Information

NPI Number	:	1811906654
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES E BOYD MD

Provider Business Mailing Address
First Line	:	9850 GENESEE AVE
Second Line	:	SUITE 355
City	:	LA JOLLA
State	:	CA
Zip	:	92037-1224
Country	:	US
Telephone Number	:	858-202-0011
Fax Number	:	858-202-0055

Provider Business Practice Location Address
First Line	:	2658 DEL MAR HEIGHTS RD
Second Line	:	BOX# 369
City	:	DEL MAR
State	:	CA
Zip	:	92014-3100
Country	:	US
Telephone Number	:	858-335-3792
Fax Number	:	858-225-7057

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

Provider Enumeration Date	:	08/07/2006
Last Update Date	:	02/01/2013

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