Organization
DR. MIKE AND FRIENDS PEDIATRICS,P.C.
Active
Other names
Dr.Mike and Friends Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MIGUEL VICTOR LANZA M.D. (PRESIDENT)
(541) 267-2020
Entity
Organization
Contact information
Practice address
1925 THOMPSON RD, COOS BAY, OR 97420-2040
(541) 267-2020
(541) 267-0123
Mailing address
1925 THOMPSON RD, COOS BAY, OR 97420-2040
(541) 267-2020
(541) 267-0123
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD24551
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912209883
—
OR
Enumeration date
12/09/2013
Last updated
12/09/2013
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