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Individual

PAUL S IMPERIA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1333 E BARNETT RD, MEDFORD, OR 97504-8219
(541) 779-4711
(541) 779-0796
Mailing address
1333 E BARNETT RD, MEDFORD, OR 97504-8219
(541) 779-4711
(541) 779-0796

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
17163
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
001191005
BLUE CROSS BLUE SHIELD
05
031026
OR
01
180014364
RAILROAD MEDICARE
Enumeration date
12/01/2006
Last updated
01/14/2011
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