KPG OREGON LLC NPI 1730552845

NPI Information

NPI: 1730552845
Provider Name: KPG OREGON, LLC
Classification: Internal Medicine - 207RA0401X
Entity Type: Organization

Specialization: Addiction Medicine

Address:
486 12TH STREET #200
ASTORIA, OR
ZIP 97103
Phone: (310) 975-1428
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KPG OREGON, LLC is an addiction medicine internal medicine in Astoria, OR. The provider is an internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. KPG OREGON, LLC NPI is 1730552845. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

486 12TH STREET #200
ASTORIA, OR
ZIP 97103
Phone: (310) 975-1428

The provider's authorized official is Darryl Olivier .
The authorized official title is Coo and has the following contact phone number (310) 975-1450.

The enumeration date for this NPI number is 11/11/2015 and was last updated on 4/12/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RA0401X	Internal Medicine	Addiction Medicine	MD168198	OREGON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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