Individual
XAVIER AL-MATEEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
6348 W EMERALD ST, BOISE, ID 83704-8732
(208) 302-0900
(208) 302-0955
Mailing address
PO BOX 190930, BOISE, ID 83719-0930
(208) 367-5170
(208) 367-5180
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
M-17735
ID
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/14/2020
Last updated
05/23/2024
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