Provider Demographics
NPI:1760704035
Name:VICTOR A. ORANUSI MD INC
Entity Type:Organization
Organization Name:VICTOR A. ORANUSI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:COMFORT
Authorized Official - Middle Name:A
Authorized Official - Last Name:MCCLAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:310-537-2588
Mailing Address - Street 1:3611 MARTIN LUTHER KING JR BLVD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:LYNWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90262-2685
Mailing Address - Country:US
Mailing Address - Phone:310-537-2588
Mailing Address - Fax:310-537-9456
Practice Address - Street 1:3611 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:SUITE 108
Practice Address - City:LYNWOOD
Practice Address - State:CA
Practice Address - Zip Code:90262-2685
Practice Address - Country:US
Practice Address - Phone:310-537-2588
Practice Address - Fax:310-537-9456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-26
Last Update Date:2010-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA63000261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center