Healthcare Provider Details

I. General information

NPI: 1114732369
Provider Name (Legal Business Name): ORION HEALTH PLAN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/12/2025
Last Update Date: 05/22/2025
Certification Date: 05/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 N CENTRAL AVE FL 17
GLENDALE CA
91203-1439
US

IV. Provider business mailing address

PO BOX 3582
GLENDALE CA
91221-3582
US

V. Phone/Fax

Practice location:
  • Phone: 323-818-7018
  • Fax: 888-998-2068
Mailing address:
  • Phone: 323-818-7018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302R00000X
TaxonomyHealth Maintenance Organization
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code305R00000X
TaxonomyPreferred Provider Organization
License Number
License Number State

VIII. Authorized Official

Name: KYLE MINASSIAN
Title or Position: CEO
Credential:
Phone: 323-818-7018