Healthcare Provider Details

I. General information

NPI: 1598247751
Provider Name (Legal Business Name): ORLAND LOMIBAO ANDAYA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 10/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9333 IMPERIAL HWY
DOWNEY CA
90242-2812
US

IV. Provider business mailing address

869 ORCHID WAY UNIT C
AZUSA CA
91702-7131
US

V. Phone/Fax

Practice location:
  • Phone: 800-823-4040
  • Fax:
Mailing address:
  • Phone: 626-393-1997
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number33041
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: