Provider Demographics
NPI:1164773388
Name:BLANKA ORLOFF MD, INC
Entity Type:Organization
Organization Name:BLANKA ORLOFF MD, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ANESTHESIOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:BLANKA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ORLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:818-848-0590
Mailing Address - Street 1:2701 W ALAMEDA AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:BURBANK
Mailing Address - State:CA
Mailing Address - Zip Code:91505-4409
Mailing Address - Country:US
Mailing Address - Phone:818-848-0590
Mailing Address - Fax:
Practice Address - Street 1:2701 W ALAMEDA AVE STE 401
Practice Address - Street 2:
Practice Address - City:BURBANK
Practice Address - State:CA
Practice Address - Zip Code:91505-4409
Practice Address - Country:US
Practice Address - Phone:818-848-0590
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-27
Last Update Date:2012-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG71818207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1902086978OtherNPI