Individual
CHELLA R BHAGYAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
70 BOWER DR STE 240, MEDFORD, OR 97501-3689
(541) 732-8790
(541) 732-3415
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(541) 732-8790
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
DO211472
OR
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
DO211472
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500807581
—
OR
Enumeration date
03/24/2018
Last updated
11/29/2023
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