Mr Modesto King Andrew Esguerra Formilleza V, OTR is a
Occupational Therapist - Physical Rehabilitation based in Creswell, Oregon. Mr Modesto King Andrew Esguerra Formilleza V is licensed to practice in Oregon (license number 260743) and his current practice location is
735 S 2nd St, Creswell, Oregon. He can be reached at his office (for appointments etc.) via phone at
(541) 895-3333.
NPI number for Mr Modesto King Andrew Esguerra Formilleza V is 1285944561 and his current mailing address is 4001 Potter St Apt 47, Eugene, Oregon. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1285944561.
Healthcare Provider's Profile
| Full Name | Mr Modesto King Andrew Esguerra Formilleza V |
|---|
| Gender | Male |
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| Speciality | Occupational Therapist - Physical Rehabilitation |
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| Location | 735 S 2nd St, Creswell, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1285944561
- Provider Enumeration Date: 10/20/2010
- Last Update Date: 10/20/2010
Medical Identifiers
Medical identifiers for Mr Modesto King Andrew Esguerra Formilleza V such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1285944561 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 225XP0019X | Occupational Therapist - Physical Rehabilitation | 260743 (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mr Modesto King Andrew Esguerra Formilleza V is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mr Modesto King Andrew Esguerra Formilleza V, OTR 4001 Potter St Apt 47, Eugene, OR 97405-4583 Ph: (541) 912-5595 | Mr Modesto King Andrew Esguerra Formilleza V, OTR 735 S 2nd St, Creswell, OR 97426-7507 Ph: (541) 895-3333 |
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