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Individual

DR. DERRICK JOHN SORWEIDE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
200 MULLINS DR, LEBANON, OR 97355-3983
(514) 259-0216
(541) 259-0680
Mailing address
795 E 2ND ST, SUITE 5, POMONA, CA 91766-2007
(909) 865-2565
(909) 865-2955

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
DO20800
OR
208M00000X
Hospitalist Physician
Primary
DO20800
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
135288
OR
Enumeration date
02/27/2006
Last updated
03/25/2021
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