Provider Demographics
NPI:1689921603
Name:ORELLANA, ENRIQUE JR (DO)
Entity Type:Individual
Prefix:DR
First Name:ENRIQUE
Middle Name:
Last Name:ORELLANA
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:2643 PATTERSON RD
Mailing Address - Street 2:SUITE 605
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-1936
Mailing Address - Country:US
Mailing Address - Phone:970-244-2482
Mailing Address - Fax:970-255-1701
Practice Address - Street 1:2643 PATTERSON RD
Practice Address - Street 2:SUITE 605
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1936
Practice Address - Country:US
Practice Address - Phone:970-244-2482
Practice Address - Fax:970-255-1701
Is Sole Proprietor?:No
Enumeration Date:2012-08-08
Last Update Date:2019-03-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO54919207RC0000X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO56557728Medicaid
CO416881ZGEEMedicare PIN