Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Functional Medicine of Idaho PC

Organization Family Medicine Physician · NPI 1336656040

Functional Medicine of Idaho PC provides Family Medicine Physician services in Boise, Idaho. Registered with an NPI since 2018.

In the registry since
2018
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

3858 N Garden Center Way Ste 100
Boise, ID 83703-5008
Phone: (208) 385-7711
Fax: (208) 385-0346
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X

Record details

NPI number1336656040
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Samuel Warren — President · (208) 385-7711
NPI enumeratedJanuary 3, 2018
Last updated in NPPESJanuary 3, 2018
Mailing address3858 N Garden Center Way Ste 100, Boise, ID 83703-5008

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