Individual
JOSEBA BIDABURU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3280 E LANARK DR, MERIDIAN, ID 83642-5982
(208) 895-8670
(208) 955-0494
Mailing address
PO BOX 191050, BOISE, ID 83719-1050
(208) 985-1423
(208) 955-6501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA-2742
ID
390200000X
Student in an Organized Health Care Education/Training Program
—
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Other
Enumeration date
06/10/2022
Last updated
04/25/2024
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