Eric Russell Boudreau M.D.

NPI 1295091395 - Student in an Organized Health Care Education/Training Program - 390200000X

NPI Details
NPI 1295091395
Gender Male
Enumeration Date 04/03/2012
Last Updated 06/20/2013
Entity Type Individual
Active Over 4 years ago
Practice Location
200 W ARBOR DR
#8770
SAN DIEGO CA, 92103-9000, US
Phone (619) 543-5720
Fax (619) 543-6476
Business Location
200 W ARBOR DR
#8770
SAN DIEGO CA, 92103-9000, US
Phone
Fax
Toxanomy
Taxonomy Code 390200000X
License State
License Number
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According to our database, Eric Russell Boudreau M.D. NPI is 1295091395, taxonomy code is 390200000X Eric Russell Boudreau M.D. physically located at 200 W Arbor Dr, San Diego CA, 92103-9000. NPI Number Eric Russell Boudreau M.D. has the Individual type.

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1295091395 NPI number is provided on an as is basis without warranty of any kind. 1295091395 is maintained by the National Plan & Provider Enumeration System. The contents of Eric Russell Boudreau M.D. are for informational purposes only.