Provider Demographics
NPI:1740360445
Name:ORZECK, ELISE ESTHER (DPM)
Entity type:Individual
Prefix:DR
First Name:ELISE
Middle Name:ESTHER
Last Name:ORZECK
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22035 ALIZONDO DR
Mailing Address - Street 2:
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91364-4902
Mailing Address - Country:US
Mailing Address - Phone:818-346-8568
Mailing Address - Fax:818-704-7894
Practice Address - Street 1:22035 ALIZONDO DR
Practice Address - Street 2:
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91364-4902
Practice Address - Country:US
Practice Address - Phone:818-704-7894
Practice Address - Fax:818-704-7894
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE3923213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E3923Medicare ID - Type Unspecified
U51017Medicare UPIN