Organization
PAIN INSTITUTE OF OREGON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL C BALOG M.D. (MEDICAL DIRECTOR)
(503) 238-7246
Entity
Organization
Contact information
Practice address
527 SE CESAR E CHAVEZ BLVD, PORTLAND, OR 97214-3214
(503) 238-7246
(503) 238-7248
Mailing address
527 SE CESAR E CHAVEZ BLVD, PORTLAND, OR 97214-3214
(503) 238-7246
(503) 238-7248
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD19519
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074062
—
OR
Enumeration date
06/18/2010
Last updated
02/27/2013
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