Individual
DR. BASIL PITTENGER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
150 S WALL ST, COOS BAY, OR 97420-3233
(541) 435-7200
Mailing address
150 S WALL ST, COOS BAY, OR 97420-3233
(541) 435-7200
(541) 888-0025
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD25030
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407812365
NBMC GROUP NPI NUMBER
OR
05
—
275268
—
OR
01
—
CB3544
RR MEDICARE GROUP NUMBER
OR
01
—
P00143347
RR MEDICARE PTAN NUMBER
OR
01
—
R0000WFBTV
MEDICARE GROUP PIN NUMBER
OR
Enumeration date
12/09/2005
Last updated
04/13/2026
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