| Charles H Toledo, MD | |
|
1750 Thompson Rd, Coos Bay, OR 97420-2100 | |
| (541) 269-0333 | |
| (541) 269-7389 |
| Full Name | Charles H Toledo |
|---|---|
| Gender | Male |
| Speciality | Pediatrics |
| Location | 1750 Thompson Rd, Coos Bay, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427103472 | NPI | - | NPPES |
| 500752265 | Medicaid | OR | |
| 6983577 | Medicaid | NC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | 31398 (North Carolina) | Secondary |
| 208000000X | Pediatrics | MD189415 (Oregon) | Primary |
| Entity Name | Dlp Western Carolina Physician Practices Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609281641 PECOS PAC ID: 9032338975 Enrollment ID: O20140908002531 |
| Mailing Address | Practice Location Address |
|---|---|
| Charles H Toledo, MD 1750 Thompson Rd, Coos Bay, OR 97420-2195 Ph: (541) 269-0333 | Charles H Toledo, MD 1750 Thompson Rd, Coos Bay, OR 97420-2100 Ph: (541) 269-0333 |
Dr. Donna Lee Rabin, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151 Fax: 541-266-4501 | |
Kevin H Molteni, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151 | |
Dr. Mary Lynn Moore, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1750 Thompson Rd, Coos Bay, OR 97420 Phone: 541-269-0333 Fax: 541-269-7389 | |
Dr. Jenni Conner Deleon, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151 Fax: 541-266-4579 | |
Dr. Cassandra Kay Hastings, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151 Fax: 541-266-4566 | |
Dr. Kariktan Cruz, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151 Fax: 541-266-4501 | |
Dr. Dale Preston Henken, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1900 Woodland Dr, Coos Bay, OR 97420 Phone: 541-267-5151 Fax: 541-266-4562 |