Healthcare Provider Details

I. General information

NPI: 1225970650
Provider Name (Legal Business Name): CORAL OROS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2026
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S OLIVE ST # 1200
LOS ANGELES CA
90015-2211
US

IV. Provider business mailing address

1150 S OLIVE ST
LOS ANGELES CA
90015-2211
US

V. Phone/Fax

Practice location:
  • Phone: 213-783-0096
  • Fax:
Mailing address:
  • Phone: 213-783-0096
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: