Healthcare Provider Details

I. General information

NPI: 1164773388
Provider Name (Legal Business Name): BLANKA ORLOFF MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2012
Last Update Date: 09/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 W ALAMEDA AVE STE 401
BURBANK CA
91505-4409
US

IV. Provider business mailing address

2701 W ALAMEDA AVE STE 401
BURBANK CA
91505-4409
US

V. Phone/Fax

Practice location:
  • Phone: 818-848-0590
  • Fax:
Mailing address:
  • Phone: 818-848-0590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberG71818
License Number StateCA

VIII. Authorized Official

Name: BLANKA ANN ORLOFF
Title or Position: ANESTHESIOLOGIST
Credential: M.D
Phone: 818-848-0590