Healthcare Provider Details

I. General information

NPI: 1952974784
Provider Name (Legal Business Name): ELOY ESPINOZA MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: E E E MD, MPH

II. Dates (important events)

Enumeration Date: 07/20/2021
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 W IRONWOOD DR STE 258
COEUR D ALENE ID
83814-4400
US

IV. Provider business mailing address

700 W IRONWOOD DR STE 258
COEUR D ALENE ID
83814-4400
US

V. Phone/Fax

Practice location:
  • Phone: 208-625-6877
  • Fax: 208-625-6878
Mailing address:
  • Phone: 208-625-6877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMT223162
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number7071562
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: