Healthcare Provider Details

I. General information

NPI: 1184677486
Provider Name (Legal Business Name): CHARLES LOUIS OROFINO P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHUCK OROFINO P.T.

II. Dates (important events)

Enumeration Date: 05/18/2006
Last Update Date: 12/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3106 PONTE MORINO DR SUITE A
CAMERON PARK CA
95682-8277
US

IV. Provider business mailing address

3106 PONTE MORINO DR SUITE A
CAMERON PARK CA
95682-8277
US

V. Phone/Fax

Practice location:
  • Phone: 530-677-7565
  • Fax: 530-677-7683
Mailing address:
  • Phone: 530-677-7565
  • Fax: 530-677-7683

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT11494
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: