Provider Demographics
NPI:1639114259
Name:ORRILLO, ELVIA ELIZABETH (MD)
Entity Type:Individual
Prefix:DR
First Name:ELVIA
Middle Name:ELIZABETH
Last Name:ORRILLO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELVIA
Other - Middle Name:ELIZABETH
Other - Last Name:ORRILLO BLAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:433 W SANTA CLARA AVE
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92706-2546
Mailing Address - Country:US
Mailing Address - Phone:714-973-0989
Mailing Address - Fax:714-973-0180
Practice Address - Street 1:3865 JACKSON ST
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92503-3919
Practice Address - Country:US
Practice Address - Phone:951-352-5666
Practice Address - Fax:951-352-5445
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2008-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62912207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A629120Medicaid
CAWA62912BMedicare PIN
CA00A629120Medicaid
CAH22486Medicare UPIN