Basic Information
| Provider Information | |||||||||
| NPI: | 1518366475 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOE | ||||||||
| FirstName: | ERIC | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3750 CONVOY ST STE 201 | ||||||||
| Address2: | |||||||||
| City: | SAN DIEGO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 921113770 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8582788031 | ||||||||
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| Practice Location | |||||||||
| Address1: | 9101 KANIS RD STE 401 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722056450 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5012173533 | ||||||||
| FaxNumber: | 5012173578 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/17/2014 | ||||||||
| LastUpdateDate: | 08/10/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 08/10/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 20A17275 | CA | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.