Provider Demographics
NPI:1770797060
Name:ALUL, IDA (MD)
Entity type:Individual
Prefix:DR
First Name:IDA
Middle Name:
Last Name:ALUL
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Gender:F
Credentials:MD
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Mailing Address - Street 1:2450 NE MARY ROSE PL
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-7132
Mailing Address - Country:US
Mailing Address - Phone:541-318-8388
Mailing Address - Fax:541-318-7145
Practice Address - Street 1:2450 NE MARY ROSE PL
Practice Address - Street 2:SUITE 110
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-7132
Practice Address - Country:US
Practice Address - Phone:541-318-8388
Practice Address - Fax:541-318-7145
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2024-10-07
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Provider Licenses
StateLicense IDTaxonomies
ORMD23027207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287214Medicaid
OR287214Medicaid
ORR111663Medicare PIN