NPI 1003693961

Riverside Primary Care Adult and Geriatric Medicine Plllp

Organisation Geriatric Medicine (Family Medicine) Physician Boise, ID

Practice location

Address: 1673 W Shoreline Dr STE 100, Boise, ID 83702-6749
Phone: (208) 593-3054

Authorised official

Name: Jessica Long
Title: Co-Owner
Phone: (208) 850-1940

Registered specialties

Geriatric Medicine (Family Medicine) Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207QG0300X

Other Family Medicine providers in Idaho →

Registry record

NPI: 1003693961
Entity type: Organization
NPI issued: 13 Sep 2023
Record last updated: 13 Sep 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.