Botimer, Gary D

Botimer, Gary D is an individual health care provider with primary practice located at 25455 Barton Rd Ste 102B, Loma Linda CA 92354-3128. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Botimer, Gary D can be contacted via phone (909) 558-2808.

Contact Information

Primary practice address
25455 Barton Rd Ste 102B Loma Linda CA 92354-3128
Phone: (909) 558-2808
Fax: (909) 558-5599
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X M4699 Idaho

Profile Details

NPI number 1124018114
LBN Legal business name Botimer, Gary D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 21st, 2005
Last updated Feb 18th, 2015 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124018114 NPPES
Idaho Other 000010147414 BLUE SHIELD
Idaho Other 000010005946 BLUE SHIELD
Idaho Other B0891 BLUE SHIELD
Idaho Other 200011749 BLUE SHIELD
Idaho Other 46995 BLUE SHIELD
Idaho MEDICAID 002363100 BLUE SHIELD
Idaho Other 33555 BLUE SHIELD
Idaho Other 000010005947 BLUE SHIELD

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