Organization
P3 HEALTH PARTNERS-OREGON LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIR BACCHUS MD (CMO)
(702) 910-3950
Entity
Organization
Contact information
Practice address
2525 12TH ST SE STE 240250, SALEM, OR 97302-2281
(971) 701-9058
Mailing address
2370 CORPORATE CIR STE 300, HENDERSON, NV 89074-7760
(702) 910-3950
(702) 778-2264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
208D00000X
General Practice Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
OR
Enumeration date
07/24/2020
Last updated
07/24/2020
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