Provider Demographics
NPI:1407837487
Name:ORAVEC, RICHARD G (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:G
Last Name:ORAVEC
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:6200 WILSHIRE BLVD
Mailing Address - Street 2:STE 1510
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048-5801
Mailing Address - Country:US
Mailing Address - Phone:323-964-1440
Mailing Address - Fax:323-937-5283
Practice Address - Street 1:6200 WILSHIRE BLVD
Practice Address - Street 2:SUITE 1510
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048-5801
Practice Address - Country:US
Practice Address - Phone:323-964-1440
Practice Address - Fax:323-964-1462
Is Sole Proprietor?:No
Enumeration Date:2005-11-08
Last Update Date:2012-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA20A7730207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF00042Medicare UPIN