Provider Demographics
NPI:1982887618
Name:CHARLES R OROZCO MD PC
Entity Type:Organization
Organization Name:CHARLES R OROZCO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:A
Authorized Official - Last Name:OROZCO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:602-206-7606
Mailing Address - Street 1:4250 E CAMELBACK RD
Mailing Address - Street 2:SUITE K-250
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-8301
Mailing Address - Country:US
Mailing Address - Phone:602-253-9026
Mailing Address - Fax:602-252-6391
Practice Address - Street 1:4250 E CAMELBACK RD
Practice Address - Street 2:SUITE K-250
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-8301
Practice Address - Country:US
Practice Address - Phone:602-253-9026
Practice Address - Fax:602-252-6391
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2007-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19458207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ63070OtherMEDICARE GROUP NUMBER