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KEITH BOSTON M.D. FAMILY PRACTICE NPI 1013104975


NPI Information

NPI: 1013104975
Provider Name: KEITH BOSTON, M.D. FAMILY PRACTICE
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
3150 GILMORE ST
PLACERVILLE, CA
ZIP 95667
Phone: (530) 622-4884
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KEITH BOSTON, M.D. FAMILY PRACTICE is a family medicine in Placerville, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. KEITH BOSTON, M.D. FAMILY PRACTICE NPI is 1013104975. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

3150 GILMORE ST
PLACERVILLE, CA
ZIP 95667-500
Phone: (530) 622-4884
Fax: (530) 622-1303

The provider's authorized official is Keith J Boston .
The authorized official title is Owner and has the following contact phone number (530) 622-4884.

The enumeration date for this NPI number is 9/25/2007 and was last updated on 9/25/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineG53533CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100G535530MEDICARE PINCALIFORNIA
200G535530MEDICAIDCALIFORNIA
3E24920MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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