Provider Demographics
NPI:1285810689
Name:OSBORN, MEGAN BOYSEN (MD)
Entity type:Individual
Prefix:DR
First Name:MEGAN
Middle Name:BOYSEN
Last Name:OSBORN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:MARIE
Other - Last Name:BOYSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:101 THE CITY DR. RTE 128
Mailing Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868
Mailing Address - Country:US
Mailing Address - Phone:714-456-5705
Mailing Address - Fax:714-456-3714
Practice Address - Street 1:101 THE CITY DR. RTE 128
Practice Address - Street 2:DEPARTMENT OF EMERGENCY MEDICINE
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868
Practice Address - Country:US
Practice Address - Phone:714-456-5705
Practice Address - Fax:714-456-3714
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2012-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA106761207P00000X
CANOT RECEIVED YET207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine