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An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Medical Specialty |
261QM2500X |
| NPI Number | 1023165594 |
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| LBN Legal business name | EASTSIDE INTERNAL MEDICINE PLLC | ||||
| Authorized official | DOUGLAS PORTELANCE - (MD PRESIDENT) | ||||
| Entity | Organization | ||||
| Organization subpart 1 | No | ||||
| Enumeration date | 01/05/2007 | ||||
| Last updated | 12/18/2007 - About 18 years ago | ||||
| Identifiers |
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EASTSIDE INTERNAL MEDICINE PLLC