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OREGON RETINA SPECIALISTS LLC NPI 1285812123


NPI Information

NPI: 1285812123
Provider Name: OREGON RETINA SPECIALISTS, LLC

Doing Business As: OREGON RETINA CENTER

Classification: Ophthalmology - 207WX0107X
Entity Type: Organization

Specialization: Retina Specialist

CLIA Number: 38D2114571

Address:
1518 E BARNETT RD
MEDFORD, OR
ZIP 97504
Phone: (541) 770-2020
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OREGON RETINA SPECIALISTS, LLC is a retina specialist ophthalmology in Medford, OR. The provider is an ophthalmologist who specializes in the diagnosis and treatment of vitreoretinal diseases. OREGON RETINA SPECIALISTS, LLC NPI is 1285812123. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Oregon Retina Center.

The provider's business location address is:

1518 E BARNETT RD
MEDFORD, OR
ZIP 97504-281
Phone: (541) 770-2020
Fax: (541) 200-2599

The provider's authorized official is Yujen Wang .
The authorized official title is Member and has the following contact phone number (541) 770-2020.

The CLIA number assigned to this NPI record is 38D2114571 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2008 and was last updated on 12/3/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207WX0107XOphthalmologyRetina Specialist492778-90OREGONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1218700MEDICAIDOREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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