Individual
DR. JENNIFER G. GOTTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2328 N TOWERVIEW LN, BOISE, ID 83702-6518
(626) 578-4010
Mailing address
2328 N TOWERVIEW LN, BOISE, ID 83702-6518
(626) 578-4010
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
A73025
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A73025
MED. LICENSE
CA
01
—
D3079847
CA DRIVER'S LICENSE
CA
Enumeration date
12/05/2005
Last updated
04/05/2013
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