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SANJOG BASTOLA MD

Individual Provider (NPI-1) Active

Internal Medicine

Provider Information

NPI Number
1922459064
Provider Type
Individual Provider (NPI-1)
Credentials
MD
Status
Active

Contact & Location

Address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR, 972393011
Phone
(503) 494-6594
Fax
(503) 494-4285

Specialties & Taxonomies

Internal Medicine License: MI #4301109761
Hospitalist License: OR #MD191319
Internal Medicine Primary License: OR #1922459064

All Addresses

MAILING

1400 SW 5TH AVE STE 500

PORTLAND, OR, 972015537

(866) 617-6855

LOCATION

3181 SW SAM JACKSON PARK RD

PORTLAND, OR, 972393011

(503) 494-6594