Individual
DR. MIGUEL VICTOR LANZA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1957 THOMPSON RD, COOS BAY, OR 97420
(541) 267-2020
(541) 267-0123
Mailing address
1957 THOMPSON RD, COOS BAY, OR 97420
(541) 267-2020
(541) 267-0123
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD24551
OR
208000000X
Pediatrics Physician
Primary
MD#227196
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
227196
—
OR
Enumeration date
08/01/2006
Last updated
03/07/2014
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