Provider Demographics
NPI:1922198795
Name:LEO E. ORR, JR., M.D., INC.
Entity Type:Organization
Organization Name:LEO E. ORR, JR., M.D., INC.
Other - Org Name:LEO E. ORR, JR., M.D.
Other - Org Type:Other Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:C
Authorized Official - Last Name:VENTURA
Authorized Official - Suffix:
Authorized Official - Credentials:HCI
Authorized Official - Phone:213-481-3948
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC35803207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C358031Medicaid
CADB208AOtherPTAN MEDICARE
CAC35803OtherCALIFORNIA STATE LICENSE
CA00C358030Medicaid
CA00C358030Medicaid
CAC35803OtherCALIFORNIA STATE LICENSE
CA00C358031Medicaid