Lanza, Miguel Victor

Lanza, Miguel Victor is an individual health care provider with primary practice located at 1957 Thompson Rd , Coos Bay OR 97420. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Pediatrics, Other Service Providers / Specialist. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Lanza, Miguel Victor can be contacted via phone (541) 267-2020.

Contact Information

Primary practice address
1957 Thompson Rd Coos Bay OR 97420
Phone: (541) 267-2020
Fax: (541) 267-0123
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X MD#227196 Oregon
Other Service Providers / Specialist 174400000X MD24551 Oregon

Profile Details

NPI number 1760499115
LBN Legal business name Lanza, Miguel Victor
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 1st, 2006
Last updated Mar 7th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760499115 NPPES
Oregon MEDICAID 227196

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