| Dr Jenni Conner Deleon, MD | |
|
1900 Woodland Dr, Coos Bay, OR 97420-0000 | |
| (541) 267-5151 | |
| (541) 266-4579 |
| Full Name | Dr Jenni Conner Deleon |
|---|---|
| Gender | Female |
| Speciality | Pediatrics |
| Location | 1900 Woodland Dr, 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 |
|---|---|---|---|
| 1215911045 | NPI | - | NPPES |
| 022756 | Medicaid | OR | |
| 1407812365 | Other | OR | NBMC NPI NUMBER-GROUP |
| 930635514 | Other | OR | GROUP TAX ID |
| R0000WFBTV | Other | OR | MEDICARE GROUP PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208000000X | Pediatrics | MD25369 (Oregon) | Primary |
| Entity Name | North Bend Medical Center Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407812365 PECOS PAC ID: 5597677716 Enrollment ID: O20031105000138 |
| Entity Name | Bay Area Hospital District |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1225016561 PECOS PAC ID: 2163331000 Enrollment ID: O20040310000301 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Jenni Conner Deleon, MD 1900 Woodland Dr, Coos Bay, OR 97420-0000 Ph: (541) 267-5151 | Dr Jenni Conner Deleon, MD 1900 Woodland Dr, Coos Bay, OR 97420-0000 Ph: (541) 267-5151 |
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. 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 |