Organization
ODDVAR A. MYHRE, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ODDVAR A MYHRE M.D. (PRESIDENT)
(310) 963-5739
Entity
Organization
Contact information
Practice address
79146 CETRINO, LA QUINTA, CA 92253-6544
(310) 963-5739
(310) 545-8561
Mailing address
79146 CETRINO, LA QUINTA, CA 92253-6544
(310) 963-5739
(310) 545-8561
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
A22327
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A223270
BLUE CROSS OF CA
CA
05
—
00A223270
—
CA
Enumeration date
11/17/2006
Last updated
10/08/2007
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