Provider Demographics
NPI:1821032608
Name:TROUM, ORRIN M (MD)
Entity type:Individual
Prefix:
First Name:ORRIN
Middle Name:M
Last Name:TROUM
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 1:2336 SANTA MONICA BLVD
Mailing Address - Street 2:STE 207
Mailing Address - City:SANTA MONICA
Mailing Address - State:CA
Mailing Address - Zip Code:90404-2095
Mailing Address - Country:US
Mailing Address - Phone:310-449-1999
Mailing Address - Fax:310-449-1996
Practice Address - Street 1:2336 SANTA MONICA BLVD STE 207
Practice Address - Street 2:
Practice Address - City:SANTA MONICA
Practice Address - State:CA
Practice Address - Zip Code:90404-2067
Practice Address - Country:US
Practice Address - Phone:310-449-1999
Practice Address - Fax:310-453-8533
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-15
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA37014207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
A84948Medicare UPIN