Provider Demographics
NPI:1659304830
Name:BOXER, REBECCA S (MD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:S
Last Name:BOXER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2315 STOCKTON BLVD STE 2P101
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817-2201
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2315 STOCKTON BLVD STE 2P101
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2201
Practice Address - Country:US
Practice Address - Phone:916-734-8608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68213207RG0300X
OH35086476207RC0000X
CODR.0061302207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000382820OtherANTHEM
OH363377OtherWELLCARE
OH7344225OtherAETNA
000000224390OtherUNISON
OH2592805Medicaid
000000530383OtherANTHEM UHMG
OHP00272156OtherRAILROAD MEDICARE
CO028945OtherKAISER COMMERCIAL NUMBER
CO38887037Medicaid
OH363377OtherWELLCARE