| Keith Boston, M.d. Family Practice | |
| 
					3150 Gilmore St Placerville CA 95667-5500  | |
| (530) 622-4884 | |
| (530) 622-1303 | 
| Full Name | Keith Boston, M.d. Family Practice | 
|---|---|
| Speciality | Family Medicine | 
| Location | 3150 Gilmore St, Placerville, California | 
| Authorized Official Name and Position | Keith J Boston (OWNER) | 
| Authorized Official Contact | 5306224884 | 
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Keith Boston, M.d. Family Practice 3150 Gilmore St Placerville CA 95667-5500 Ph: (530) 622-4884  | Keith Boston, M.d. Family Practice 3150 Gilmore St Placerville CA 95667-5500 Ph: (530) 622-4884  | 
| NPI Number | 1013104975 | 
|---|---|
| Provider Enumeration Date | 09/25/2007 | 
| Last Update Date | 09/25/2007 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1013104975 | NPI | - | NPPES | 
| 00G535530 | Medicaid | CA | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 207Q00000X | Family Medicine | G53533 (California) | Primary | 
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