=====================================================
General NPI Number Information
=====================================================
NPI Number | 1821032608
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ORRIN M TROUM MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/15/2006
-----------------------------------------------------
Last Update Date | 04/20/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2336 SANTA MONICA BLVD STE 207
-----------------------------------------------------
City | SANTA MONICA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90404-2067
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-449-1999
-----------------------------------------------------
Fax | 310-453-8533
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2336 SANTA MONICA BLVD STE 207
-----------------------------------------------------
City | SANTA MONICA
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90404-2095
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-449-1999
-----------------------------------------------------
Fax | 310-449-1996
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RR0500X
-----------------------------------------------------
Taxonomy Name | Rheumatology Physician
-----------------------------------------------------
License Number | A37014
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------