Organization
CARLOS CEBALLOS, MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CARLOS CEBALLOS MD (OWNER)
(503) 650-4359
Entity
Organization
Contact information
Practice address
10373 NE HANCOCK ST STE 216, PORTLAND, OR 97220-3873
(503) 650-4359
(503) 650-6913
Mailing address
PO BOX 53, GLADSTONE, OR 97027-0053
(503) 650-4359
(503) 650-6913
Taxonomy
Speciality
Code
Description
License number
State
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
04/11/2007
Last updated
08/22/2020
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