Provider Demographics
NPI:1073576054
Name:BOYD, RALPH O (MD)
Entity Type:Individual
Prefix:
First Name:RALPH
Middle Name:O
Last Name:BOYD
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1560 E. CHEVY CHASE DRIVE
Mailing Address - Street 2:#245
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204
Mailing Address - Country:US
Mailing Address - Phone:818-246-5900
Mailing Address - Fax:323-478-9454
Practice Address - Street 1:1560 E. CHEVY CHASE DRIVE
Practice Address - Street 2:#245
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204
Practice Address - Country:US
Practice Address - Phone:818-246-5900
Practice Address - Fax:323-478-9454
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2010-04-26
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Provider Licenses
StateLicense IDTaxonomies
CAA37837207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG10073Medicare UPIN