IndividualActive
Landon Grange, M.D.
NPI 1043620255 · Ophthalmology Physician · Boise, ID
Provider details
- NPI number
- 1043620255
- Entity type
- Individual
- Primary specialty
- Ophthalmology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- M14219 (ID)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
5680 W Gage St
Boise, ID 83706
Phone: (208) 773-3937
Fax: (208) 377-3937
Approximate (ZIP-level) locationGet directions
Mailing address
3867 Miramar St
La Jolla, CA 92037-1312
Registry dates
- Enumerated
- 2014-04-28
- Last updated
- 2018-07-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.