Dr. Mike and Friends Pediatrics,P.C.

Primary specialty

SpecialistTaxonomy code 174400000X

License

MD24551 Issued in OR

Legal business name

DR. MIKE AND FRIENDS PEDIATRICS,P.C.

Practice address

1925 Thompson Rd
Coos Bay, OR 97420-2040

Phone

(541) 267-2020

Fax

(541) 267-0123

NPI assigned

Dec 9, 2013

Organization subpart

No

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

Authorized official

Name

Miguel Victor Lanza, M.D.

Title

President

Phone

(541) 267-2020

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Dr.Mike and Friends Pediatrics Former legal business name

Locations

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

{
    "created_epoch": "1386547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1386547200000",
    "number": "1891126363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1925 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202040",
            "telephone_number": "541-267-2020",
            "fax_number": "541-267-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1925 THOMPSON RD",
            "city": "COOS BAY",
            "state": "OR",
            "postal_code": "974202040",
            "telephone_number": "541-267-2020",
            "fax_number": "541-267-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MIKE AND FRIENDS PEDIATRICS,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-12-09",
        "last_updated": "2013-12-09",
        "status": "A",
        "authorized_official_last_name": "LANZA",
        "authorized_official_first_name": "MIGUEL",
        "authorized_official_middle_name": "VICTOR",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "541-267-2020",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "OR",
            "license": "MD24551",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1912209883",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr.Mike and Friends Pediatrics",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jesse Allen Dorfmeister, FNP
• Lina Dorfmeister, CRNA
• Erin Lynn Dozhier, QMHP-R
• Dr. King Scope Clinic, LLC
• Dr. Mike & Friends Pediatrics PC
• Ginger M Drake
• Patricia K Dudas, CFNP
• Audrey M Duke, FNP
• Stephanie Marie Dulian, CRNA
• Early Intervention Early Childhood Special Education

• Specialist in Coos Bay, OR
• Providers in Coos Bay, OR by specialty
• Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2013; 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.