Provider Demographics
NPI:1659581700
Name:BOYD, RASHAD (IDC)
Entity Type:Individual
Prefix:
First Name:RASHAD
Middle Name:
Last Name:BOYD
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2740 PENINSULA RD APT 222
Mailing Address - Street 2:
Mailing Address - City:OXNARD
Mailing Address - State:CA
Mailing Address - Zip Code:93035-4033
Mailing Address - Country:US
Mailing Address - Phone:310-469-4509
Mailing Address - Fax:
Practice Address - Street 1:2740 PENINSULA RD APT 222
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93035-4033
Practice Address - Country:US
Practice Address - Phone:310-469-4509
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman