Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | MD201659 | OR |
Y | 111NI0900X | Internist | MD201659 | OR |
NPI | 1003201476 |
---|---|
Provider Name | Alanna Mozena |
First Address | Bend, OR 97701-6051 |
Second Address | Bend, OR 97701-6051 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2015 |
Last Update Date | 27/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
500791956 | (05) | OR |