MEDICARE: MR. LUIS R OROZCO MSW, LCSW

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	225400000X	Rehabilitation Practitioner
2	1041C0700X	Clinical Social Worker	LCS 29812	CA

General Provider Information

NPI Number	:	1265521322
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LUIS R OROZCO MSW, LCSW

Provider Business Mailing Address
First Line	:	PO BOX 4369
Second Line	:
City	:	MONTEBELLO
State	:	CA
Zip	:	90640-9307
Country	:	US
Telephone Number	:	213-805-5427
Fax Number	:

Provider Business Practice Location Address
First Line	:	3435 WILSHIRE BLVD
Second Line	:	SUITE 2700
City	:	LOS ANGELES
State	:	CA
Zip	:	90010-1901
Country	:	US
Telephone Number	:	213-805-5427
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	04/29/2014

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