Provider Demographics
NPI:1235338005
Name:EDITHA C. ORLINO-OLIVA A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:EDITHA C. ORLINO-OLIVA A MEDICAL CORPORATION
Other - Org Name:EDITHA O OLIVA MD INC
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:EDITHA
Authorized Official - Middle Name:CACHO
Authorized Official - Last Name:ORLINO-OLIVA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-241-5272
Mailing Address - Street 1:2135 AIRPARK DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-2433
Mailing Address - Country:US
Mailing Address - Phone:530-241-5272
Mailing Address - Fax:530-241-3729
Practice Address - Street 1:2135 AIRPARK DR
Practice Address - Street 2:SUITE A
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2433
Practice Address - Country:US
Practice Address - Phone:530-241-5272
Practice Address - Fax:530-241-3729
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32395207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A323950Medicaid
CA3276238Medicare PIN
CA00A323950Medicaid