Provider Demographics
NPI:1922199694
Name:FRIENDS & FAMILY MEDICAL CLINIC, INC.
Entity type:Organization
Organization Name:FRIENDS & FAMILY MEDICAL CLINIC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MARJAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SADEGHPANAHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:424-533-3186
Mailing Address - Street 1:303 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-3713
Mailing Address - Country:US
Mailing Address - Phone:208-899-8379
Mailing Address - Fax:877-737-5511
Practice Address - Street 1:303 2ND AVE S
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-3713
Practice Address - Country:US
Practice Address - Phone:208-899-8379
Practice Address - Fax:877-737-5511
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-27
Last Update Date:2025-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty