Organization
CHINIKO LLC
Active
Other names
Eye Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
DARRELL GENSTLER MD (OWNER)
(541) 928-1667
Entity
Organization
Contact information
Practice address
2700 14TH AVE SE, ALBANY, OR 97322
(541) 928-1667
(541) 928-1817
Mailing address
2700 14TH AVE SE, ALBANY, OR 97322
(541) 928-1667
(541) 928-1817
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
071514
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158905
—
OR
01
—
490003810
RAILROAD MEDICARE
—
Enumeration date
09/15/2006
Last updated
06/01/2009
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