Provider Demographics
NPI:1083787691
Name:ORRIN M TROUM AND MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:ORRIN M TROUM AND MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORRIN
Authorized Official - Middle Name:M
Authorized Official - Last Name:TROUM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-449-1999
Mailing Address - Street 1:2336 SANTA MONICA BLVD
Mailing Address - Street 2:
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2095
Mailing Address - Country:US
Mailing Address - Phone:310-449-1999
Mailing Address - Fax:
Practice Address - Street 1:2336 SANTA MONICA BLVD
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2095
Practice Address - Country:US
Practice Address - Phone:310-449-1999
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37014207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0078440Medicaid
CAGR0078440Medicaid
CAW13775AMedicare ID - Type UnspecifiedMEDICARE