Healthcare Provider Details

I. General information

NPI: 1326050303
Provider Name (Legal Business Name): NORA FRANCISCO DE LA PAZ MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 W IDAHO AVE STE 101
ONTARIO OR
97914-2155
US

IV. Provider business mailing address

932 W IDAHO AVE STE 101
ONTARIO OR
97914-2155
US

V. Phone/Fax

Practice location:
  • Phone: 541-889-6476
  • Fax: 541-889-7403
Mailing address:
  • Phone: 541-889-6476
  • Fax: 541-889-7403

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD10648
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: