Healthcare Provider Details

I. General information

NPI: 1760345714
Provider Name (Legal Business Name): CRISTINA OROZCO
Entity Type: Individual
Gender:
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2025
Last Update Date: 12/06/2025
Certification Date: 12/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 S LA CIENEGA BLVD STE 250
BEVERLY HILLS CA
90211-3357
US

IV. Provider business mailing address

14800 ROXTON AVE
GARDENA CA
90249-3751
US

V. Phone/Fax

Practice location:
  • Phone: 310-954-9614
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P0010X
TaxonomyPediatric Rehabilitation Medicine Physician
License Number52236
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: