Healthcare Provider Details

I. General information

NPI: 1568599876
Provider Name (Legal Business Name): CARLOS ORREGO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 06/17/2025
Certification Date: 06/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

438 E SOUTHERN AVE STE 101
PHOENIX AZ
85040-3046
US

IV. Provider business mailing address

PO BOX 37337
PHOENIX AZ
85069-7337
US

V. Phone/Fax

Practice location:
  • Phone: 623-439-9494
  • Fax: 623-439-9495
Mailing address:
  • Phone: 623-439-9494
  • Fax: 623-439-9495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number51183
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RA0001X
TaxonomyAdvanced Heart Failure and Transplant Cardiology Physician
License Number51183
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: