Provider Demographics
NPI:1629075247
Name:BOSS, DONALD JEFFREY (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:JEFFREY
Last Name:BOSS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:27520 HAWTHORNE BLVD. #220
Mailing Address - Street 2:
Mailing Address - City:ROLLING HILLS ESTATES
Mailing Address - State:CA
Mailing Address - Zip Code:90274-3580
Mailing Address - Country:US
Mailing Address - Phone:310-706-4440
Mailing Address - Fax:310-706-4441
Practice Address - Street 1:27520 HAWTHORNE BLVD. #220
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS ESTATES
Practice Address - State:CA
Practice Address - Zip Code:90274-3580
Practice Address - Country:US
Practice Address - Phone:310-706-4440
Practice Address - Fax:310-706-4441
Is Sole Proprietor?:No
Enumeration Date:2005-06-29
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG3832202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology