Keith Boston, M.d. Family Practice

NPI 1013104975 - Family Medicine - 207Q00000X

NPI Details
NPI 1013104975
Enumeration Date 09/25/2007
Last Updated 09/25/2007
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name KEITH J KEITH
Position OWNER
Phone (530) 622-4884
Fax (530) 622-1303
Practice Location
3150 GILMORE ST
PLACERVILLE CA, 95667-5500, US
Phone (530) 622-4884
Fax (530) 622-1303
Business Location
3150 GILMORE ST
PLACERVILLE CA, 95667-5500, US
Phone (530) 622-4884
Fax (530) 622-1303
Toxanomy
Taxonomy Code 207Q00000X
License State California
License Number G53533
Remove 1013104975 NPI Number
 

According to our database, Keith Boston, M.d. Family Practice NPI is 1013104975, taxonomy code is 207Q00000X and license number is G53533, license state is located at California. Keith Boston, M.d. Family Practice physically located at 3150 Gilmore St, Placerville CA, 95667-5500. NPI Number 1033115704 has the healthcare provider type.

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1013104975 NPI number is provided on an as is basis without warranty of any kind. 1013104975 is maintained by the National Plan & Provider Enumeration System. The contents of Keith Boston, M.d. Family Practice are for informational purposes only.