Jerry Michael Bolduan, MD
Jerry Michael Bolduan is a General Practice Physician provider (General Practice) practicing in Sebastopol, CA, registered in the NPPES registry with NPI 1396043758 since 2011. The credential MD stands for Doctor of Medicine.
✓ Active NPI ✓ Valid NPI checksum Sole proprietor
| NPI | 1396043758 |
|---|---|
| Entity type | Individual (Type 1) |
| Name | Jerry Michael Bolduan |
| Credential | MD |
| Sex | Male |
| Practice address | Sebastopol, CA, 95472 |
| Phone | 7078235583 |
| Enumeration date | 2011-03-09 |
| Last updated in NPPES | 2011-03-09 |
Street address withheld — NPPES sole-proprietor addresses can be home addresses. See our data policy.
Taxonomy & licenses
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 208D00000X | General Practice Physician | Primary | G032312 | CA |
MD — Doctor of Medicine: A physician who completed medical school (allopathic medicine), residency training, and state licensure. About the MD credential
Copy-ready billing details
Provider: Jerry Bolduan, MD NPI: 1396043758 Taxonomy: 208D00000X (General Practice Physician) Address: Sebastopol, CA, 95472
Verify this record
Cross-check NPI 1396043758 against the authoritative CMS record: view Jerry Michael Bolduan on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
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Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2011-03-09.