=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992856231
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | CHRISTOPHER J. ORENIC, O.D. INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/15/2007
-----------------------------------------------------
Last Update Date | 11/26/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2101 ROSECRANS AVE STE 1215
-----------------------------------------------------
City | EL SEGUNDO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90245-4749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-210-6990
-----------------------------------------------------
Fax | 310-321-6170
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2101 ROSECRANS AVE STE 1215
-----------------------------------------------------
City | EL SEGUNDO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90245-4749
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 310-210-6990
-----------------------------------------------------
Fax | 310-321-6170
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. CHRISTOPHER J ORENIC
-----------------------------------------------------
Credential | O.D.
-----------------------------------------------------
Telephone | 310-321-6990
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 152W00000X
-----------------------------------------------------
Taxonomy Name | Optometrist
-----------------------------------------------------
License Number | OPT 10056 TPL
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------