Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Riverside Primary Care Adult and Geriatric Medicine Plllp

Organization Geriatric Medicine (Family Medicine) Physician · NPI 1003693961

Riverside Primary Care Adult and Geriatric Medicine Plllp provides Geriatric Medicine (Family Medicine) Physician services in Boise, Idaho. Registered with an NPI since 2023.

In the registry since
2023

Practice location Address checks out

1673 W Shoreline Dr Ste 100
Boise, ID 83702-6749
Phone: (208) 593-3054
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Family Medicine) Physician (primary) Taxonomy 207QG0300X

Record details

NPI number1003693961
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Jessica Long — Co-Owner · (208) 850-1940
NPI enumeratedSeptember 13, 2023
Last updated in NPPESSeptember 13, 2023
Certification dateSeptember 13, 2023
Mailing address1673 W Shoreline Dr Ste 100, Boise, ID 83702-6749

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