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Individual

GUANG FAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-8276
Mailing address
3181 SW SAM JACKSON PARK ROAD, MAIL CODE L471, PORTLAND, OR 97239

Taxonomy

Speciality
Code
Description
License number
State
207ZH0000X
Hematology (Pathology) Physician
Primary
MD23079
OR
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD23079
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
228925
OR
Enumeration date
08/03/2006
Last updated
07/16/2007
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