Provider Demographics
NPI:1518981232
Name:DE ORIO, JOSEPH J (MD)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:DE ORIO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6226 E SPRING ST
Mailing Address - Street 2:SUITE 260
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1423
Mailing Address - Country:US
Mailing Address - Phone:562-283-4876
Mailing Address - Fax:562-731-2926
Practice Address - Street 1:6226 E SPRING ST
Practice Address - Street 2:SUITE 260
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1423
Practice Address - Country:US
Practice Address - Phone:562-283-4876
Practice Address - Fax:562-731-2926
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036-116500208800000X
CAA75800208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL001619727OtherBCBS OF ILLINOIS
CA1518981232OtherNPI
CAA75800OtherCA LICENSE
ILDE0395OtherRAILROAD MEDICARE GROUP
IL036116500Medicaid
ILP00338636OtherRAILROAD MEDICARE
IL212223OtherMEDICARE GROUP
IL001619727OtherBCBS OF ILLINOIS
IL5514060015Medicare NSC
CA954588009OtherEIN
CA1518981232OtherNPI
IL5514060005Medicare NSC
IL001619727OtherBCBS OF ILLINOIS