Individual
NOEL C PENSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
94220 4TH ST, GOLD BEACH, OR 97444-7756
(702) 453-3799
Mailing address
89351 SUNNY LOOP LN, BANDON, OR 97411-6346
(702) 453-3799
(702) 453-5741
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0004928
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500724810
—
OR
Enumeration date
08/14/2013
Last updated
07/18/2023
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