MEDICARE: BLANKA ORLOFF MD, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	G71818	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1902086978	OTHER	CA	NPI

General Provider Information

NPI Number	:	1164773388
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BLANKA ORLOFF MD, INC

Provider Business Mailing Address
First Line	:	2701 W ALAMEDA AVE STE 401
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4409
Country	:	US
Telephone Number	:	818-848-0590
Fax Number	:

Provider Business Practice Location Address
First Line	:	2701 W ALAMEDA AVE STE 401
Second Line	:
City	:	BURBANK
State	:	CA
Zip	:	91505-4409
Country	:	US
Telephone Number	:	818-848-0590
Fax Number	:

Authorized Official
Title or Position	:	ANESTHESIOLOGIST
Name	:	BLANKA ANN ORLOFF
Credential	:	M.D
Telephone Number	:	818-848-0590

Provider Enumeration Date	:	09/27/2012
Last Update Date	:	09/27/2012

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