Molly Omizo, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

MD17366 Issued in OR

Practice address

2200 NE Neff Rd
Suite 302
Bend, OR 97701-4283

Phone

(541) 388-3978

Fax

(541) 278-8366

NPI assigned

Jun 24, 2008

Last updated

Mar 5, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1214265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1393977600000",
    "number": "1326209131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 490",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977090490",
            "telephone_number": "541-388-3978",
            "fax_number": "541-278-8366"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 NE NEFF RD",
            "address_2": "SUITE 302",
            "city": "BEND",
            "state": "OR",
            "postal_code": "977014283",
            "telephone_number": "541-388-3978",
            "fax_number": "541-278-8366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OMIZO",
        "first_name": "MOLLY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-24",
        "last_updated": "2014-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OR",
            "license": "MD17366",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD17366",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Olson, LMT, MMP
• Scott Chambers Olson, M.D.
• Scott Vincent Olson, DC
• Richard Ombrembowski, PA
• Omhc, LLC (Oregon Man Clinics)
• Russ Tatsuto Kalani Omizo, M.D.
• On the Go Kinesio
• Michael J. Ondo, D.D.S.
• Anne Onishi, M.D.
• Onsight Eye Center, LLC

• Internal Medicine Physician in Bend, OR
• Providers in Bend, OR by specialty
• Internal Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.