Mir Clinic, P.c. | |
2155 Nw 173rd Ave Ste 102 Beaverton OR 97006-3563 | |
(503) 531-9990 | |
(503) 531-9996 |
Full Name | Mir Clinic, P.c. |
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Speciality | Internal Medicine |
Location | 2155 Nw 173rd Ave Ste 102, Beaverton, Oregon |
Authorized Official Name and Position | Mehdi M Mirtorabi (PRESIDENT) |
Authorized Official Contact | 5035319990 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Mir Clinic, P.c. 2155 Nw 173rd Ave Ste 102 Beaverton OR 97006-3563 Ph: (503) 531-9990 | Mir Clinic, P.c. 2155 Nw 173rd Ave Ste 102 Beaverton OR 97006-3563 Ph: (503) 531-9990 |
NPI Number | 1639353378 |
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Provider Enumeration Date | 12/18/2007 |
Last Update Date | 12/18/2007 |
Medicare PECOS PAC ID | 9931136553 |
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Medicare Enrollment ID | O20050725001130 |
Identifier | Type | State | Issuer |
---|---|---|---|
1639353378 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | MD22580 (Oregon) | Primary |
Provider Name | Mehdi Mike Mirtorabi |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1679509111 PECOS PAC ID: 7618929233 Enrollment ID: I20050211000356 |
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