MEDICARE: MANOHAR MULKI PUNJA MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RC0000X	Cardiovascular Disease Physician	MD08438	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1245222512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MANOHAR MULKI PUNJA MD

Provider Business Mailing Address
First Line	:	975 SE SANDY BLVD
Second Line	:	SUITE 200
City	:	PORTLAND
State	:	OR
Zip	:	97214-1308
Country	:	US
Telephone Number	:	503-963-2846
Fax Number	:	503-963-9505

Provider Business Practice Location Address
First Line	:	24900 SE STARK ST
Second Line	:	SUITE 103
City	:	GRESHAM
State	:	OR
Zip	:	97030-3355
Country	:	US
Telephone Number	:	503-665-4278
Fax Number	:	503-665-7766

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	07/09/2007

Similar Medicare Providers

1255308631 — SAKINEH ILIAIFAR X MD
Practice Location Address:

24900 SE STARK ST , SUITE #110
GRESHAM, OR
97030-3355

Practice Phone: 503-465-6850
Practice Fax:

1861553232 — KAREN MEES OT
Practice Location Address:

24900 SE STARK ST , SUITE 106
GRESHAM, OR
97030-3355

Practice Phone: 503-413-3879
Practice Fax: 503-413-4379

1205997681 — CRAIG PLUMMER PT
Practice Location Address:

24900 SE STARK ST , SUITE 106
GRESHAM, OR
97030-3355

Practice Phone: 503-413-3879
Practice Fax: 503-413-4379

1861520991 — MTN. VIEW FAMILY PRACTICE, PC
Practice Location Address:

24900 SE STARK ST , SUITE 205
GRESHAM, OR
97030-3355

Practice Phone: 503-665-1010
Practice Fax: 503-665-1023

1710110127 — ROBERT L KALEZ MD PC
Practice Location Address:

24900 SE STARK ST , 208
GRESHAM, OR
97030-3355

Practice Phone: 503-666-3030
Practice Fax: 503-666-3434

1942552062 — RICHARD S POLIN PC
Practice Location Address:

24900 SE STARK ST , SUITE 208
GRESHAM, OR
97030-3355

Practice Phone: 503-666-8139
Practice Fax: 503-666-3434

Directions to “ MANOHAR MULKI PUNJA MD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.