Provider Demographics
NPI:1841562816
Name:BOATRIGHT, SEAN (CP)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:BOATRIGHT
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 LA CASA VIA STE 202
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3007
Mailing Address - Country:US
Mailing Address - Phone:925-930-7700
Mailing Address - Fax:
Practice Address - Street 1:120 LA CASA VIA STE 202
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3007
Practice Address - Country:US
Practice Address - Phone:925-930-7700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-06
Last Update Date:2012-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist