Provider Demographics
NPI:1285116665
Name:BOMAN, CHRISTOPHER (DC)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:BOMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39400 MURRIETA HOT SPRINGS RD STE 122B
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92563-7709
Mailing Address - Country:US
Mailing Address - Phone:951-698-4848
Mailing Address - Fax:619-684-3983
Practice Address - Street 1:39400 MURRIETA HOT SPRINGS RD STE 122B
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92563-7709
Practice Address - Country:US
Practice Address - Phone:951-698-4848
Practice Address - Fax:619-684-3983
Is Sole Proprietor?:No
Enumeration Date:2018-09-03
Last Update Date:2018-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA33319111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor