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General NPI Number Information
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NPI Number | 1063428308
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Entity Type | Organization
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Legal Business Name | NORTH BEND MEDICAL CENTER INC
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 12/07/2023
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Provider Practice Location Address
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Address Line | 1900 WOODLAND DR
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City | COOS BAY
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State | OR
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Zip | 97420-0000
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Country | US
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Telephone | 541-267-5151
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Fax | 541-266-4501
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Provider Business Mailing Address
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Address Line | 1900 WOODLAND DR
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City | COOS BAY
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State | OR
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Zip | 97420-0000
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Country | US
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Telephone | 541-267-5151
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Fax | 541-266-4501
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Authorized Official
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Title or Position | INTERIM CEO
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Name | STEVEN A TERSIGNI
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Credential | MD
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Telephone | 541-267-5151
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085P0229X
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Taxonomy Name | Pediatric Radiology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2085U0001X
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Taxonomy Name | Diagnostic Ultrasound Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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