Dana Anthony Boardman, D.C.
Individual provider Active NPI Chiropractor · Lagunitas, CA
NPI 1639467459 · NPPES record last updated Jul 13, 2011
Key facts
- NPI
- 1639467459
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Chiropractor 111N00000X
- License
- 29430 (CA)
- Practice address
- 7282 Sir Francis Drake Blvd.
Suite B
Lagunitas, CA 94938 - Phone
- (415) 488-4300
- NPI assigned
- Jul 13, 2011
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 29430 | CA | MD | Registered Respiratory Therapist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 29430 | CA | Yes |
Addresses
Primary practice location
7282 Sir Francis Drake Blvd.
Suite B
Lagunitas, CA 94938
Mailing address
PO Box 24
Lagunitas, CA 94938-0024
Phone (415) 488-4300
Other providers in Lagunitas, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 13, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.