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Individual

MICHAEL THOMAS FORINO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
431 S BATAVIA ST, STE. 103, ORANGE, CA 92868-3936
(714) 538-6731
(714) 771-8369
Mailing address
PO BOX 14005, ORANGE, CA 92863-1405
(714) 571-5000
(714) 571-5055

Taxonomy

Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
G76890
CA
2085R0202X
Diagnostic Radiology Physician
Primary
G76890
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G768900
BLUE SHIELD OF CA
05
00G768900
CA
01
00G768900 159
CALOPTIMA
01
053304CG32896
TRAILBLAZER
01
P00144972
RAILROAD MEDICARE
Enumeration date
07/18/2005
Last updated
08/15/2008
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