Provider Demographics
NPI:1972628477
Name:ORVIK, JEREMY S (MD)
Entity Type:Individual
Prefix:
First Name:JEREMY
Middle Name:S
Last Name:ORVIK
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:444 E HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:ARCADIA
Mailing Address - State:CA
Mailing Address - Zip Code:91006-6203
Mailing Address - Country:US
Mailing Address - Phone:626-447-0296
Mailing Address - Fax:626-447-6057
Practice Address - Street 1:2107 LIVINGSTON ST
Practice Address - Street 2:SUITE A
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94606-5218
Practice Address - Country:US
Practice Address - Phone:510-436-9001
Practice Address - Fax:510-868-3430
Is Sole Proprietor?:No
Enumeration Date:2007-03-21
Last Update Date:2021-12-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA93784207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAAW177XMedicare PIN