Provider Demographics
NPI:1295466860
Name:CERES PHYSICIANS OREGON PC
Entity Type:Organization
Organization Name:CERES PHYSICIANS OREGON PC
Other - Org Name:SPRING FERTILITY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:C
Authorized Official - Last Name:KLATSKY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-964-5618
Mailing Address - Street 1:1 DANIEL BURNHAM CT STE 110C
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-0456
Mailing Address - Country:US
Mailing Address - Phone:415-738-7868
Mailing Address - Fax:415-964-5619
Practice Address - Street 1:2055 NW SAVIER ST STE 150
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97209-1325
Practice Address - Country:US
Practice Address - Phone:415-738-7868
Practice Address - Fax:415-964-5619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-23
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive EndocrinologyGroup - Single Specialty