Provider Demographics
NPI:1588724389
Name:SKYAR, BORIS M (MD)
Entity type:Individual
Prefix:DR
First Name:BORIS
Middle Name:M
Last Name:SKYAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2374 E PACIFICA PL
Mailing Address - Street 2:
Mailing Address - City:RANCHO DOMINGUEZ
Mailing Address - State:CA
Mailing Address - Zip Code:90220-6214
Mailing Address - Country:US
Mailing Address - Phone:310-225-3244
Mailing Address - Fax:310-698-7054
Practice Address - Street 1:1225 WILSHIRE BLVD
Practice Address - Street 2:PATHOLOGY DEPT
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-1901
Practice Address - Country:US
Practice Address - Phone:213-977-2507
Practice Address - Fax:310-698-7054
Is Sole Proprietor?:No
Enumeration Date:2006-12-11
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY242930207ZP0102X
CAA98294207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABD179ZMedicare PIN