NPI 1033738505

Xavier Al-Mateen

Practitioner Student in an Organized Health Care Education/Training Program Boise, ID

Practice location

Address: 6348 W Emerald St, Boise, ID 83704-8732
Phone: (208) 302-0900
Fax: (208) 302-0955
Mailing address: PO Box 190930, Boise, ID 83719-0930

Registered specialties (2)

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

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Psychiatry Physician

Allopathic & Osteopathic Physicians Taxonomy 2084P0800X Licence M-17735 (ID)

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Registry record

NPI: 1033738505
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 Apr 2020
Record last updated: 23 May 2024

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.