Provider Demographics
NPI:1912376534
Name:FUSION HEALTH SERVICES
Entity Type:Organization
Organization Name:FUSION HEALTH SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LOUIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PENG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-407-8286
Mailing Address - Street 1:2284 ROGUE WAY
Mailing Address - Street 2:
Mailing Address - City:WEST LINN
Mailing Address - State:OR
Mailing Address - Zip Code:97068-8322
Mailing Address - Country:US
Mailing Address - Phone:503-407-8286
Mailing Address - Fax:
Practice Address - Street 1:2284 ROGUE WAY
Practice Address - Street 2:
Practice Address - City:WEST LINN
Practice Address - State:OR
Practice Address - Zip Code:97068-8322
Practice Address - Country:US
Practice Address - Phone:503-407-8286
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR207QA0401X207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty