Provider Demographics
NPI:1700806759
Name:ORR, CHERYL HILTY (MD)
Entity Type:Individual
Prefix:DR
First Name:CHERYL
Middle Name:HILTY
Last Name:ORR
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:CHERYL
Other - Middle Name:ANN
Other - Last Name:HILTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1967 KICKAPOO ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH LAKE TAHOE
Mailing Address - State:CA
Mailing Address - Zip Code:96150-5381
Mailing Address - Country:US
Mailing Address - Phone:530-573-1594
Mailing Address - Fax:
Practice Address - Street 1:2170 SOUTH AVE
Practice Address - Street 2:BARTON MEMORIAL HOSPITAL- SURGERY
Practice Address - City:SOUTH LAKE TAHOE
Practice Address - State:CA
Practice Address - Zip Code:96150-7026
Practice Address - Country:US
Practice Address - Phone:530-543-5880
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-20
Last Update Date:2010-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA77242207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A722420Medicaid
CA00A722420OtherBLUE SHIELD
CA00A722420OtherBLUE SHIELD
CA00A722420Medicaid