Healthcare Provider Details

I. General information

NPI: 1649460015
Provider Name (Legal Business Name): HALPERIN AND MICHEL ODS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2007
Last Update Date: 04/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 MAIN AVE SUITE A
TILLAMOOK OR
97141-3760
US

IV. Provider business mailing address

800 MAIN AVE SUITE A
TILLAMOOK OR
97141-3760
US

V. Phone/Fax

Practice location:
  • Phone: 503-842-5568
  • Fax: 503-842-1122
Mailing address:
  • Phone: 503-842-5568
  • Fax: 503-842-1122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. ERIC HALPERIN
Title or Position: PRESIDENT
Credential: O.D.
Phone: 503-842-5568