A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
General Practice |
208D00000X | 99 | Physician/Undefined Physician type[6] |
| NPI # | 1710003140 |
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| LBN Legal business name | OPTUMCARE PORTLAND LLC | ||||||||
| Authorized official | BRENDA CASTILLO - (REVENUE CYCLE MANAGER) | ||||||||
| Entity | Organization | ||||||||
| Organization subpart 1 | No | ||||||||
| Enumeration date | 03/21/2007 | ||||||||
| Last updated | 12/05/2022 - About 3 years ago | ||||||||
| Identifiers |
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