MEDICARE: DR. JEFFREY D ORR MD

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	207Q00000X	Family Medicine Physician	A137630	CA

General Provider Information

NPI Number	:	1336401702
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY D ORR MD

Provider Business Mailing Address
First Line	:	PO BOX 1649
Second Line	:
City	:	BIG BEAR LAKE
State	:	CA
Zip	:	92315-1649
Country	:	US
Telephone Number	:	909-878-8246
Fax Number	:

Provider Business Practice Location Address
First Line	:	41820 GARSTIN DR
Second Line	:
City	:	BIG BEAR LAKE
State	:	CA
Zip	:	92315-1649
Country	:	US
Telephone Number	:	909-878-8246
Fax Number	:

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

Provider Enumeration Date	:	06/12/2012
Last Update Date	:	11/02/2016

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