| Rob M Kassan M D LLC | |
|
1105 Se Centennial St Bend OR 97702-1343 | |
| (541) 241-6471 | |
| Not Available |
| Full Name | Rob M Kassan M D LLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 1105 Se Centennial St, Bend, Oregon |
| Authorized Official Name and Position | Rob Kassan (OWNER) |
| Authorized Official Contact | 3106507813 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rob M Kassan M D LLC 445 Nutcracker Dr Redmond OR 97756-7329 Ph: (310) 650-7813 | Rob M Kassan M D LLC 1105 Se Centennial St Bend OR 97702-1343 Ph: (541) 241-6471 |
| NPI Number | 1740073741 |
|---|---|
| Provider Enumeration Date | 05/23/2025 |
| Last Update Date | 06/05/2025 |
| Certification Date | 06/05/2025 |
| Medicare PECOS PAC ID | 5890208839 |
|---|---|
| Medicare Enrollment ID | O20250702000658 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740073741 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Primary |
| Provider Name | Rob Mitchell Kassan |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1487681417 PECOS PAC ID: 6608058516 Enrollment ID: I20220825001760 |
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