Healthcare Provider Details

I. General information

NPI: 1740360445
Provider Name (Legal Business Name): ELISE ESTHER ORZECK DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22035 ALIZONDO DR
WOODLAND HILLS CA
91364-4902
US

IV. Provider business mailing address

22035 ALIZONDO DR
WOODLAND HILLS CA
91364-4902
US

V. Phone/Fax

Practice location:
  • Phone: 818-704-7894
  • Fax: 818-704-7894
Mailing address:
  • Phone: 818-346-8568
  • Fax: 818-704-7894

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberE3923
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: