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General NPI Number Information
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NPI Number | 1922199694
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Entity Type | Organization
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Legal Business Name | FRIENDS & FAMILY MEDICAL CLINIC, INC.
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Dates
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Enumeration Date | 09/27/2006
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Last Update Date | 01/21/2025
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Provider Practice Location Address
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Address Line | 303 2ND AVE S
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City | NAMPA
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State | ID
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Zip | 83651-3713
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Country | US
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Telephone | 208-899-8379
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Fax | 877-737-5511
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Provider Business Mailing Address
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Address Line | 303 2ND AVE S
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City | NAMPA
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State | ID
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Zip | 83651-3713
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Country | US
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Telephone | 208-899-8379
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Fax | 877-737-5511
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARJAN SADEGHPANAHI
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Credential | M.D.
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Telephone | 424-533-3186
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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