Clyde Francis Boiston, PT, OCS

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT 23165 Issued in CA

Practice address

29650 Bradley Rd
Sun City, CA 92586-6521

Phone

(951) 672-0455

NPI assigned

Jun 3, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fairbanks & Power Physical Therapy Corp.

  • Physical Therapist
  • Irvine, CA
  • NPI 1912953936
  NPD (past)
• Walker Physical Therapy, Inc

  • Physical Therapist
  • Sun City, CA
  • NPI 1154411650
  NPD (past)

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

{
    "created_epoch": "1149292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1740228709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29650 BRADLEY RD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925866521",
            "telephone_number": "951-672-0455"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29650 BRADLEY RD",
            "city": "SUN CITY",
            "state": "CA",
            "postal_code": "925866521",
            "telephone_number": "951-672-0455"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOISTON",
        "first_name": "CLYDE",
        "middle_name": "FRANCIS",
        "credential": "PT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 23165",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "PT0147050",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Claudia Susana Ascencio
• At Will Speech Therapy and Educational Services Inc.
• Yajaria Avila, RBT
• Jasmine Beverly, BEHAVIOR ANALYST
• Arely Aide Birch
• Bradley Road Holdings LLC
• Joyce Y Brennan, PT
• Brian L Nguyen MD, Inc
• Carol Linn Brown, PT
• Michael R Bryant, DDS

• Physical Therapist in Sun City, CA
• Providers in Sun City, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.