| Dr Long Earon Thao, DO | |
|
24800 Se Stark St, Gresham, OR 97030-3378 | |
| (503) 413-8407 | |
| Not Available |
| Full Name | Dr Long Earon Thao |
|---|---|
| Gender | Male |
| Speciality | Hospitalist |
| Location | 24800 Se Stark St, Gresham, Oregon |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770780165 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208M00000X | Hospitalist | DO27806 (Oregon) | Primary |
| Entity Name | Permanente Medical Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073606299 PECOS PAC ID: 8921910225 Enrollment ID: O20031104000710 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Long Earon Thao, DO 2650 Ne 6th Pl, Portland, OR 97212-3880 Ph: (503) 867-7530 | Dr Long Earon Thao, DO 24800 Se Stark St, Gresham, OR 97030-3378 Ph: (503) 413-8407 |
Dr. Gordon Johnson, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 24988 Se Stark St, Gresham, OR 97030 Phone: 503-331-2376 | |
Dr. Deborah A Alexander, MD Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 24800 Se Stark St, Gresham, OR 97030 Phone: 503-413-8407 Fax: 503-413-6951 | |
Sandip Biswas, Hospitalist Medicare: Accepting Medicare Assignments Practice Location: 24800 Se Stark St, Gresham, OR 97030 Phone: 503-674-1122 |