Healthcare Provider Details

I. General information

NPI: 1356329809
Provider Name (Legal Business Name): BRIAN PATRICK DESMOND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/05/2006
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 SW BONNETT WAY SUITE 1150
BEND OR
97702
US

IV. Provider business mailing address

705 SW BONNETT WAY SUITE 1150
BEND OR
97702
US

V. Phone/Fax

Practice location:
  • Phone: 541-323-2020
  • Fax: 541-323-0744
Mailing address:
  • Phone: 541-323-2020
  • Fax: 541-323-0744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberMD24958
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMD24958
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: