Provider Demographics
NPI:1487693735
Name:MURPHY, CHARLES ORLANDO (MD)
Entity type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:ORLANDO
Last Name:MURPHY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:CHARLES
Other - Middle Name:ORLANDO
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:18035 BROOKHURST ST STE 1300
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-6738
Mailing Address - Country:US
Mailing Address - Phone:657-241-9440
Mailing Address - Fax:714-665-4601
Practice Address - Street 1:18035 BROOKHURST ST STE 1300
Practice Address - Street 2:
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-6738
Practice Address - Country:US
Practice Address - Phone:657-241-9440
Practice Address - Fax:714-665-4601
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2019-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG84545208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO00G845450Medicaid
CAG84545Medicare ID - Type UnspecifiedMEDICARE NUMBER
CO00G845450Medicaid