Healthcare Provider Details

I. General information

NPI: 1336547322
Provider Name (Legal Business Name): MR. MICHAEL T ORLOFF
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2014
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3858 N GARDEN CENTER WAY STE 100
BOISE ID
83703-5008
US

IV. Provider business mailing address

4125 TRAVIS HEIGHTS RD
YREKA CA
96097-9710
US

V. Phone/Fax

Practice location:
  • Phone: 208-385-7711
  • Fax:
Mailing address:
  • Phone: 805-550-6598
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: