Keith Boston, M.D. Family Practice

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

G53533 Issued in CA

Legal business name

KEITH BOSTON, M.D. FAMILY PRACTICE

Practice address

3150 Gilmore St
Placerville, CA 95667-5500

Phone

(530) 622-4884

Fax

(530) 622-1303

NPI assigned

Sep 25, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Keith J Boston, M.D.NPI 1609953256

Title

Owner

Phone

(530) 622-4884

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Keith J Boston, M.D.

  • Family Medicine Physician
  • Placerville, CA
  • NPI 1609953256
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1190678400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1013104975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3150 GILMORE ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675500",
            "telephone_number": "530-622-4884",
            "fax_number": "530-622-1303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 GILMORE ST",
            "city": "PLACERVILLE",
            "state": "CA",
            "postal_code": "956675500",
            "telephone_number": "530-622-4884",
            "fax_number": "530-622-1303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEITH BOSTON, M.D. FAMILY PRACTICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-25",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "BOSTON",
        "authorized_official_first_name": "KEITH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "530-622-4884",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "G53533",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00G535530",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rupinder N/a Kaur
• Eileen P. Keaveny, L.C.S.W.
• Darryl L Keck, MSW
• Kelli Angela Keenan
• Ronald Lee Keil, PHARMACIST
• Alexander Keith, D.M.D.
• Denise Kellaher, D.O.
• Ann Jeanette Kenworthy, RN
• Krista Marie Key, SUDRC
• Vida Khaliki, PA

• Family Medicine Physician in Placerville, CA
• Providers in Placerville, CA by specialty
• Family Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.