| Southern Oregon Weight Healthy | |
|
749 Golf View Dr Unit A Medford OR 97504-9654 | |
| (541) 690-8231 | |
| (918) 233-2265 |
| Full Name | Southern Oregon Weight Healthy |
|---|---|
| Speciality | Internal Medicine |
| Location | 749 Golf View Dr Unit A, Medford, Oregon |
| Authorized Official Name and Position | Ee Lin Wan (PHYSICIAN) |
| Authorized Official Contact | 5416908231 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Oregon Weight Healthy 749 Golf View Dr Unit A Medford OR 97504-9654 Ph: (541) 690-8231 | Southern Oregon Weight Healthy 749 Golf View Dr Unit A Medford OR 97504-9654 Ph: (541) 690-8231 |
| NPI Number | 1689247645 |
|---|---|
| Provider Enumeration Date | 07/19/2021 |
| Last Update Date | 11/19/2021 |
| Medicare PECOS PAC ID | 2062819816 |
|---|---|
| Medicare Enrollment ID | O20210922000879 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689247645 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Ee Lin Wan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1558532317 PECOS PAC ID: 5395815641 Enrollment ID: I20080529000633 |
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Pmg Medford Physiatry Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 920 Royal Ave, Medford, OR 97504 Phone: 541-732-8400 Fax: 541-732-8401 | |
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