Provider Demographics
NPI:1407974249
Name:BOAKYE, DOUGLAS (DO)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:BOAKYE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:3878 NORTHUMBERLAND TER
Mailing Address - Street 2:
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94555-2263
Mailing Address - Country:US
Mailing Address - Phone:510-574-0273
Mailing Address - Fax:925-946-9717
Practice Address - Street 1:801 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE 250
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94596-3871
Practice Address - Country:US
Practice Address - Phone:925-946-1080
Practice Address - Fax:925-946-9717
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA20A9717208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA20A9717OtherMEDICAL LICENSE