Provider Demographics
NPI:1700839446
Name:ORLOFF, FEOKTIST NIKITOVICH (MD)
Entity Type:Individual
Prefix:
First Name:FEOKTIST
Middle Name:NIKITOVICH
Last Name:ORLOFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2440 CUMBERLAND DR
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CA
Mailing Address - Zip Code:96001-5925
Mailing Address - Country:US
Mailing Address - Phone:530-227-3699
Mailing Address - Fax:530-244-3692
Practice Address - Street 1:1950 ROSALINE AVE STE AB
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CA
Practice Address - Zip Code:96001-2543
Practice Address - Country:US
Practice Address - Phone:530-245-4801
Practice Address - Fax:530-245-4809
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-17
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA60579207R00000X, 208M00000X
CAA 60579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG58922Medicare UPIN