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Individual

JOSE GOMEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
1880 W JUDITH LANE, BOISE, ID 83705
(208) 302-5350
(208) 302-5325
Mailing address
3025 W CHERRY LN STE B, MERIDIAN, ID 83642-8531
(208) 302-5350
(208) 302-5325

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-1485
ID

Other

Enumeration date
05/11/2017
Last updated
06/20/2019
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