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ALLIANCE MEDICAL GROUP LLC NPI 1629214960


NPI Information

NPI: 1629214960
Provider Name: ALLIANCE MEDICAL GROUP, LLC

Doing Business As: PRIMARY HEALTH MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 13D0910691

Address:
4815 CLEVELAND BLVD
CALDWELL, ID
ZIP 83605
Phone: (208) 455-3545
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ALLIANCE MEDICAL GROUP, LLC is a family medicine in Caldwell, 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 1629214960. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Primary Health Medical Group.

The provider's business location address is:

4815 CLEVELAND BLVD
CALDWELL, ID
ZIP 83605-501
Phone: (208) 455-3545
Fax: (208) 454-9690

The provider's authorized official is David Peterman .
The authorized official title is President and has the following contact phone number (208) 955-6506.

The CLIA number assigned to this NPI record is 13D0910691 - 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 1/26/2022.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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