Active NPI
Charles Michael Labuwi, MD
- Pediatrics Physician
- Klamath Falls, OR
National Provider Identifier
1215022934
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 11278
- Practice address
- 2310 Mountain View Blvd
Klamath Falls, OR 97601-1134 - Phone
- (541) 883-3591
- Fax
- (541) 883-2886
- NPI assigned
- Oct 4, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 11278 | OR | Primary |
Addresses
Primary practice location
2310 Mountain View Blvd
Klamath Falls, OR 97601-1134
Mailing address
2310 Mountain View Blvd
Klamath Falls, OR 97601-1134
Phone (541) 883-3591
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 005082 | Medicaid | OR | |
| XPY183282 | Other | CA | MEDICAL OF CALIFORNIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11278 | OR | MD | Pediatrics Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215022934",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2310 MOUNTAIN VIEW BLVD",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976011134",
"telephone_number": "541-883-3591",
"fax_number": "541-883-2886"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2310 MOUNTAIN VIEW BLVD",
"city": "KLAMATH FALLS",
"state": "OR",
"postal_code": "976011134",
"telephone_number": "541-883-3591",
"fax_number": "541-883-2886"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LABUWI",
"first_name": "CHARLES",
"middle_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "OR",
"license": "11278",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "005082",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL OF CALIFORNIA",
"identifier": "XPY183282",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Klamath Falls, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.