Provider Demographics
NPI:1013483353
Name:BOYDAR MD GROUP INC
Entity Type:Organization
Organization Name:BOYDAR MD GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DARREN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:BOYER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:323-459-1543
Mailing Address - Street 1:1431 OCEAN AVE APT 1201
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90401-2147
Mailing Address - Country:US
Mailing Address - Phone:323-459-1543
Mailing Address - Fax:800-844-8259
Practice Address - Street 1:8730 GLENOAKS BLVD
Practice Address - Street 2:
Practice Address - City:SUN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:91352-2801
Practice Address - Country:US
Practice Address - Phone:818-960-7171
Practice Address - Fax:818-960-7177
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-14
Last Update Date:2019-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty