Organization
SOUTHERN OREGON GYNECOLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORETTA SANDOVAL NP, CNM (PROVIDER, OWNER)
(541) 500-4747
Entity
Organization
Contact information
Practice address
1910 E BARNETT RD STE 102, MEDFORD, OR 97504-8672
(541) 500-4747
Mailing address
1910 E BARNETT RD STE 102, MEDFORD, OR 97504-8672
(541) 500-4747
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/21/2025
Last updated
03/21/2025
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