Active NPI
Richard Gregory Boles, MD
- Clinical Genetics (M.D.) Physician
- Los Angeles, CA
National Provider Identifier
1902998511
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Genetics (M.D.) Physician
- License
- G65717
- Practice address
- 4650 W Sunset Blvd
Ms# 90
Los Angeles, CA 90027-6062 - Phone
- (323) 361-2178
- Fax
- (323) 361-5937
- NPI assigned
- Sep 29, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Genetics (M.D.) Physician | 207SG0201X | G65717 | CA | Primary |
Addresses
Primary practice location
4650 W Sunset Blvd
Ms# 90
Los Angeles, CA 90027-6062
Mailing address
6430 W Sunset Blvd
Suite 600
Los Angeles, CA 90028-7901
Phone (323) 361-2337
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00G657170 G79 | Other | CA | CAL OPTIMA |
| 00G6571710 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| G65717 | CA | MD | Clinical Genetics (M.D.) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Hospital Los Angeles | Past | Accepting new patients | |
| Children'S Hospital Los Angeles Medical Group | Clinical Genetics (M.D.) | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Children's Chronic Disease Hospital
- Los Angeles, CA
- NPI 1366527954
-
- Clinical Genetics (M.D.) Physician
- Los Angeles, CA
- NPI 1922206572
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159488000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1210723200000",
"number": "1902998511",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6430 W SUNSET BLVD",
"address_2": "SUITE 600",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900287901",
"telephone_number": "323-361-2337",
"fax_number": "323-361-8491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4650 W SUNSET BLVD",
"address_2": "MS# 90",
"city": "LOS ANGELES",
"state": "CA",
"postal_code": "900276062",
"telephone_number": "323-361-2178",
"fax_number": "323-361-5937"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLES",
"first_name": "RICHARD",
"middle_name": "GREGORY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-29",
"last_updated": "2008-05-14",
"status": "A"
},
"taxonomies": [
{
"code": "207SG0201X",
"taxonomy_group": "",
"desc": "Medical Genetics, Clinical Genetics (M.D.)",
"state": "CA",
"license": "G65717",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAL OPTIMA",
"identifier": "00G657170 G79",
"state": "CA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00G6571710",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Los Angeles, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.