Provider Demographics
NPI:1245391242
Name:BOLES, SARAH GALADRIEL (MD)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:GALADRIEL
Last Name:BOLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:GALADRIEL
Other - Last Name:MONTROSS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 232410
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92193-2410
Mailing Address - Country:US
Mailing Address - Phone:858-249-6749
Mailing Address - Fax:
Practice Address - Street 1:3855 HEALTH SCIENCES DR
Practice Address - Street 2:0987
Practice Address - City:LA JOLLA
Practice Address - State:CA
Practice Address - Zip Code:92093-0987
Practice Address - Country:US
Practice Address - Phone:858-822-6195
Practice Address - Fax:858-822-6196
Is Sole Proprietor?:No
Enumeration Date:2006-12-13
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA82562207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology