Individual
NANCY ALTAMIRANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
(541) 266-4566
Mailing address
1900 WOODLAND DR, COOS BAY, OR 97420-2099
(541) 267-5151
(541) 266-4566
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
0101056004
VA
208000000X
Pediatrics Physician
Primary
MD190330
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500759702
—
OR
01
—
C09463
GROUP PTAN
VA
Enumeration date
05/10/2006
Last updated
08/06/2019
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