Healthcare Provider Details

I. General information

NPI: 1376644500
Provider Name (Legal Business Name): GEORGE ORLOFF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/26/2006
Last Update Date: 08/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 W ALAMEDA AVE SUITE 401
BURBANK CA
91505-4402
US

IV. Provider business mailing address

2301 W ALAMEDA AVE
BURBANK CA
91506-2938
US

V. Phone/Fax

Practice location:
  • Phone: 818-848-0590
  • Fax: 818-848-3574
Mailing address:
  • Phone: 818-848-0590
  • Fax: 818-848-3574

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberG62823
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: