| Angela L House, DO | |
|
5601 W Chinden Blvd, Garden City, ID 83714-1463 | |
| (208) 809-2865 | |
| (208) 809-2866 |
| Full Name | Angela L House |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 5601 W Chinden Blvd, Garden City, Idaho |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700828241 | NPI | - | NPPES |
| 807273000 | Medicaid | ID |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | O0370 (Idaho) | Primary |
| 207Q00000X | Family Medicine | 0-0370 (Idaho) | Secondary |
| Entity Name | Alliance Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1568413920 PECOS PAC ID: 3971544685 Enrollment ID: O20050512000561 |
| Mailing Address | Practice Location Address |
|---|---|
| Angela L House, DO Po Box 191050, Suite 250, Boise, ID 83719-1050 Ph: (208) 985-1399 | Angela L House, DO 5601 W Chinden Blvd, Garden City, ID 83714-1463 Ph: (208) 809-2865 |
Christopher Ryan Boone, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 5601 W Chinden Blvd, Garden City, ID 83714 Phone: 208-809-2865 Fax: 208-809-2866 | |
Dr. Thaddeus Michael Norris, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 215 W 35th St, Garden City, ID 83714 Phone: 503-704-2415 |