John E Gamboa MD PLLC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

Legal business name

JOHN E GAMBOA MD PLLC

Doing business as

Cancer Center of Idaho

Practice address

9357 W Emerald St
Boise, ID 83704-9752

Phone

(208) 672-1000

NPI assigned

Jul 9, 2006

Last updated

Sep 3, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. John E. Gamboa, M.D.NPI 1477597045

Title

Owner

Phone

(208) 672-1000

Specialties & licenses 1

Addresses

Other names 1

• Cancer Center of Idaho Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• John E Gamboa, MD

  • Radiation Oncology Physician
  • Boise, ID
  • NPI 1477597045
  Authorized official Same address or phone
• Dustin K Bowman, PA-C

  • Physician Assistant
  • Boise, ID
  • NPI 1386680239
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283472000000",
    "number": "1689607897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9589",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837074589",
            "telephone_number": "208-472-8122",
            "fax_number": "208-344-1926"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9357 W EMERALD ST",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837049752",
            "telephone_number": "208-672-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN E GAMBOA MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2010-09-03",
        "status": "A",
        "authorized_official_last_name": "GAMBOA",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "E.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "208-672-1000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cancer Center of Idaho",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra Jocoy, RN
• Jody Sacia LLC
• Natalie Johanek
• Deanna M Johannsen, LCSW
• Timothy J Johans, MD
• John Hickey PC
• John M Bruce III DMD PC
• John M Livingston MD PA
• Katelyn Diane John, RDN, LD
• Scott Michael John, M.D.

• Radiation Oncology Physician in Boise, ID
• Providers in Boise, ID by specialty
• Radiation Oncology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.