MEDICARE: DR. RICHARD G ORAVEC D.O.

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	20A7730	CA

General Provider Information

NPI Number	:	1407837487
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. RICHARD G ORAVEC D.O.

Provider Business Mailing Address
First Line	:	6200 WILSHIRE BLVD
Second Line	:	STE 1510
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5801
Country	:	US
Telephone Number	:	323-964-1440
Fax Number	:	323-937-5283

Provider Business Practice Location Address
First Line	:	6200 WILSHIRE BLVD
Second Line	:	SUITE 1510
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5801
Country	:	US
Telephone Number	:	323-964-1440
Fax Number	:	323-964-1462

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

Provider Enumeration Date	:	11/08/2005
Last Update Date	:	08/08/2012

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