Organization
IDAHO EMERGENCY MEDICAL GROUP PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON HARDY (PE DIRECTOR)
(925) 251-6901
Entity
Organization
Contact information
Practice address
1717 ARLINGTON AVE, CALDWELL, ID 83605-4802
(208) 459-4641
(208) 455-3717
Mailing address
5000 HOPYARD RD, SUITE 100, PLEASANTON, CA 94588-3348
(925) 924-1600
(925) 924-0506
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
01/20/2016
Last updated
03/04/2020
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