Robert Bostonian

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

License

122932 Issued in CA

Practice address

67 Grande Paseo
San Rafael, CA 94903-1555

Phone

(415) 535-5554

NPI assigned

Sep 17, 2015

Last updated

Sep 17, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1442448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442448000000",
    "number": "1295104420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3517",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949123517",
            "telephone_number": "415-535-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 GRANDE PASEO",
            "city": "SAN RAFAEL",
            "state": "CA",
            "postal_code": "949031555",
            "telephone_number": "415-535-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTONIAN",
        "first_name": "ROBERT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-17",
        "last_updated": "2015-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": "CA",
            "license": "122932",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles Bookoff, MD
• Robert Dennis Bordeaux, MFTI
• Martin J Borge, D.C.
• Lani Susan Borgwardt
• Sydne K Bortel, MSW
• Jonathan R Botson, MSW
• Dawn Bottini
• Caroline Bourcier, MSPT, OCS
• Carrie Dobbin Bourguignon, PSYD
• Margaret Marie Bourne, MS CCC-SLP

• Substance Abuse Rehabilitation Facility in San Rafael, CA
• Providers in San Rafael, CA by specialty
• Substance Abuse Rehabilitation Facility in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.