Organization Name: | MICHAEL J. MASTRANGELO PC |
NPI Number: | 1053594283 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL J MASTRANGELO (OWNER) |
Mailing Address: | 2450 Mary Rose Place Suite 210 Bend |
State: | OR US |
Postal Code: | 97701 |
Phone Number: | 5413832200 |
Fax Number: | 5413835170 |
NPI Enumeration Date: | 12/11/2007 |
NPI Last Update Date: | 03/03/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | MD21444 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |