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Individual

DR. GERALDINE ANN JAVIER SOMERA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-0000
(541) 267-5151
(541) 266-4577
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-0000
(541) 267-5151
(541) 266-4577

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD26363
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0-572-799-5
ECFMG#
05
027895
OR
01
1407812365
NBMC GROUP NPI NUMBER
OR
01
CB3544
RR MEDICARE GROUP PIN
OR
01
P00302238
RR MEDICARE PTAN NUMBER
OR
01
R0000WFBTV
GROUP MEDICARE PIN NUMBER
OR
Enumeration date
12/20/2005
Last updated
02/27/2012
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