Provider Demographics
NPI:1730102286
Name:ORR, LEO E JR (MD)
Entity Type:Individual
Prefix:DR
First Name:LEO
Middle Name:E
Last Name:ORR
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1245 WILSHIRE BLVD
Mailing Address - Street 2:SUITE 801
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-4810
Mailing Address - Country:US
Mailing Address - Phone:213-481-3948
Mailing Address - Fax:213-481-1697
Practice Address - Street 1:1245 WILSHIRE BLVD
Practice Address - Street 2:SUITE 801
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4810
Practice Address - Country:US
Practice Address - Phone:213-481-3948
Practice Address - Fax:213-481-1697
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-25
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAC35803207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C358031Medicaid
CAC35803OtherCALIFORNIA LICENSE
CA00C358030Medicaid
CA00C358030Medicaid
CA00C358031Medicaid
CAA36075Medicare UPIN
CAAO6022165OtherDEA LICENSE NUMBER
CA95-3100167OtherTAX ID NUMBER