Provider Demographics
NPI:1326050303
Name:DE LA PAZ, NORA FRANCISCO (MD)
Entity Type:Individual
Prefix:
First Name:NORA
Middle Name:FRANCISCO
Last Name:DE LA PAZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 W IDAHO AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-2155
Mailing Address - Country:US
Mailing Address - Phone:541-889-6476
Mailing Address - Fax:541-889-7403
Practice Address - Street 1:932 W IDAHO AVE STE 101
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-2155
Practice Address - Country:US
Practice Address - Phone:541-889-6476
Practice Address - Fax:541-889-7403
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-11
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD10648208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR048793Medicaid
OR048793Medicaid
F64915Medicare UPIN