Provider Demographics
NPI:1609254127
Name:BOYER, MICHAEL
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:BOYER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:BOYER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC
Mailing Address - Street 1:165 S CIVIC DR STE 7
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92262-7215
Mailing Address - Country:US
Mailing Address - Phone:760-327-2287
Mailing Address - Fax:760-699-7493
Practice Address - Street 1:165 S CIVIC DR STE 7
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92262-7215
Practice Address - Country:US
Practice Address - Phone:760-327-2287
Practice Address - Fax:760-699-7493
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-16
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC5322171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1609254127OtherACUPUNCTURIST