Individual
MR. CARLOS CEBALLOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
10300 NE HANCOCK ST, PORTLAND, OR 97220
(503) 650-4359
Mailing address
PO BOX 53, GLADSTONE, OR 97027-0053
(503) 650-4359
(503) 650-6913
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD12612
OR
208VP0000X
Pain Medicine Physician
Primary
MD12612
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
225094
—
OR
Enumeration date
07/03/2006
Last updated
09/11/2025
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