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Contact Information

KPG OREGON, LLC
486 12TH STREET #200
ASTORIA, OR97103
 Phone: 310-975-1428
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Addiction Medicine

207RA0401X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for KPG OREGON, LLC

NPI Number 1730552845
LBN Legal business name KPG OREGON, LLC
Authorized official DARRYL OLIVIER - (COO)
Entity Organization
Organization subpart 1 No
Enumeration date 11/11/2015
Last updated 04/12/2018 - About 8 years ago
Identifiers
OR License # MD168198
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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