Provider Demographics
NPI:1265793020
Name:ORAVEC, RICHARD (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:ORAVEC
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4770 W HERNDON AVE STE 105
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93722-8401
Mailing Address - Country:US
Mailing Address - Phone:559-450-2663
Mailing Address - Fax:559-450-2723
Practice Address - Street 1:4770 W HERNDON AVE STE 105
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93722-8401
Practice Address - Country:US
Practice Address - Phone:559-450-2663
Practice Address - Fax:559-450-2724
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD455817207Q00000X
PAMT200938207Q00000X
CAA156769207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine