OrganizationActive
Riverside Primary Care Adult and Geriatric Medicine Plllp
NPI 1003693961 · Geriatric Medicine (Family Medicine) Physician · Boise, ID
Provider details
- NPI number
- 1003693961
- Entity type
- Organization
- Primary specialty
- Geriatric Medicine (Family Medicine) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Jessica Long, Co-Owner(208) 850-1940
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
1673 W Shoreline Dr Ste 100
Boise, ID 83702-6749
Phone: (208) 593-3054
Approximate (ZIP-level) locationGet directions
Mailing address
1673 W Shoreline Dr Ste 100
Boise, ID 83702-6749
Registry dates
- Enumerated
- 2023-09-13
- Last updated
- 2023-09-13
- Certified
- 2023-09-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.