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General NPI Number Information
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NPI Number | 1699102426
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE PAIN CONSULTANTS, LLC
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Dates
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Enumeration Date | 10/12/2013
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Last Update Date | 06/06/2019
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Provider Practice Location Address
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Address Line | 851 NE BAKER ST STE 1
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City | MCMINNVILLE
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State | OR
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Zip | 97128-4991
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Country | US
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Telephone | 503-474-3847
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Fax | 503-474-4413
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Provider Business Mailing Address
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Address Line | 851 NE BAKER ST STE 1
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City | MCMINNVILLE
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State | OR
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Zip | 97128-4991
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Country | US
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Telephone | 503-474-3847
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Fax | 503-474-4413
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Authorized Official
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Title or Position | OWNER
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Name | AHMED EBEID
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Credential | MD
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Telephone | 503-877-7941
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207LP2900X
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Taxonomy Name | Pain Medicine (Anesthesiology) Physician
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License Number | MD28743
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License Number State | OR
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