Provider Demographics
NPI:1831102037
Name:ORAVETZ, PHILIP MICHAEL (MD, MPH, MBA)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:MICHAEL
Last Name:ORAVETZ
Suffix:
Gender:M
Credentials:MD, MPH, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 AIRPORT BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:BURLINGAME
Mailing Address - State:CA
Mailing Address - Zip Code:94010-2048
Mailing Address - Country:US
Mailing Address - Phone:650-240-8089
Mailing Address - Fax:650-240-0989
Practice Address - Street 1:577 AIRPORT BLVD STE 300
Practice Address - Street 2:
Practice Address - City:BURLINGAME
Practice Address - State:CA
Practice Address - Zip Code:94010-2048
Practice Address - Country:US
Practice Address - Phone:650-240-8089
Practice Address - Fax:650-240-0989
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG061768207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine