MEDICARE: DR. RAYMOND J DORIO M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	A29371	CA
2	208D00000X	General Practice Physician	A29371	CA

General Provider Information

NPI Number	:	1205984739
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RAYMOND J DORIO M.D.

Provider Business Mailing Address
First Line	:	24237 MAIN ST
Second Line	:	SUITE 6
City	:	NEWHALL
State	:	CA
Zip	:	91321-2907
Country	:	US
Telephone Number	:	661-288-0081
Fax Number	:

Provider Business Practice Location Address
First Line	:	24237 MAIN ST
Second Line	:
City	:	NEWHALL
State	:	CA
Zip	:	91321-2907
Country	:	US
Telephone Number	:	661-259-6302
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	12/19/2016

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