Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 19458 | AZ |
NPI | 1043238744 |
---|---|
Provider Name | Charles R Orozco |
First Address | Phoenix, AZ 85018-8301 |
Second Address | Phoenix, AZ 85018-8301 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/07/2006 |
Last Update Date | 17/12/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003244 | (05) | AZ |
3343879001 | CIGNA (01) | AZ |
A78821 | (02) | |
AZ0350110 | BCBS (01) | AZ |