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Individual

I GRANT ORLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
21707 HAWTHORNE BLVD, PERFORMANCE HEALTH MEDICAL GROUP STE 101, TORRANCE, CA 90503-7010
(310) 540-9699
(310) 540-9433
Mailing address
3591 EMANUEL DR, GLENDALE, CA 91208-1133
(949) 378-6694

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G22065
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
909482
QME
CA
Enumeration date
01/17/2007
Last updated
07/08/2007
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