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Organization

DR. MIKE & FRIENDS PEDIATRICS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MICHAEL V LANZA MD (OWNER)
(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
208000000X
Pediatrics Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
227196
OR
Enumeration date
11/29/2010
Last updated
03/03/2014
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