Provider Demographics
NPI:1568743003
Name:PUNSALAN, PAOLO ANTONIO REYES (MD)
Entity Type:Individual
Prefix:DR
First Name:PAOLO ANTONIO
Middle Name:REYES
Last Name:PUNSALAN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:3181 SW SAM JACKSON PARK RD
Mailing Address - Street 2:MAILCODE OP31, OHSU ORTHOPAEDICS & REHABILITATION
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3011
Mailing Address - Country:US
Mailing Address - Phone:503-494-6406
Mailing Address - Fax:503-494-5050
Practice Address - Street 1:3181 SW SAM JACKSON PARK RD
Practice Address - Street 2:MAILCODE OP31, OHSU ORTHOPAEDICS & REHABILITATION
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3011
Practice Address - Country:US
Practice Address - Phone:503-494-6406
Practice Address - Fax:503-494-5050
Is Sole Proprietor?:No
Enumeration Date:2011-08-29
Last Update Date:2011-08-29
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Provider Licenses
StateLicense IDTaxonomies
ORFE154111207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery