Organization
PICU ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL W JANSEN M.D. (OWNER/PHYSICIAN)
(208) 429-6693
Entity
Organization
Contact information
Practice address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 429-6693
Mailing address
PO BOX 994032, REDDING, CA 96099
(530) 241-0473
(530) 241-5377
Taxonomy
Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
—
—
Other
Enumeration date
10/03/2006
Last updated
08/22/2020
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