Individual
PAVAN KUMAR K GONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3615 NW SAMARITAN DRIVE, SUITE 201, CORVALLIS, OR 97333
(541) 768-6930
(541) 768-6931
Mailing address
3615 NW SAMARITAN DRIVE, SUITE 201, CORVALLIS, OR 97333
(541) 768-6930
(541) 768-6931
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A100550
CA
207R00000X
Internal Medicine Physician
MD172330
OR
207RN0300X
Nephrology Physician
Primary
MD172330
OR
208M00000X
Hospitalist Physician
MD172330
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0A1005500
—
CA
01
—
A100550
CA MEDICAL LICENSE
CA
Enumeration date
07/18/2007
Last updated
08/27/2015
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