ALLIANCE MEDICAL GROUP LLC NPI 1497991749

NPI Information

  • NPI: 1497991749
  • Provider Name: ALLIANCE MEDICAL GROUP, LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • :
  • CLIA Number: 13D0521918
  • Address: 1907 BROADWAY AVE
    SUITE 101
    BOISE, ID
    ZIP 83706
  • Phone: (208) 345-1222

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NPI Details

ALLIANCE MEDICAL GROUP, LLC is a family medicine in Boise, ID. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. ALLIANCE MEDICAL GROUP, LLC NPI is 1497991749. The provider is registered as an organization entity type and is a multi-specialty group.
The provider .

The provider's business location address is:

1907 BROADWAY AVE
SUITE 101
BOISE, ID
ZIP 83706-201
Phone: (208) 345-1222
Fax: (208) 345-1261

The provider's authorized official is Linda Barnes .
The authorized official title is Credentialing Mgr and has the following contact phone number (208) 985-1423.

The CLIA number assigned to this NPI record is 13D0521918 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/16/2008 and was last updated on 2/17/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

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This page was last updated on: 3/30/2025

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