Individual
DR. KARIKTAN CRUZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
(541) 266-4501
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2045
(541) 267-5151
(541) 266-4501
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD125758
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1407812365
GROUP NPI
OR
01
—
161133
GROUP MEDICAID
OR
01
—
93-0635514
GROUP TAX ID FOR BILLING
OR
01
—
R0000WFBTV
GROUP MEDICARE
OR
Enumeration date
09/26/2007
Last updated
05/20/2013
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