Provider Demographics
NPI:1922344589
Name:ORCUTT, VENETIA L (PA)
Entity type:Individual
Prefix:
First Name:VENETIA
Middle Name:L
Last Name:ORCUTT
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Gender:F
Credentials:PA
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Mailing Address - Street 1:1001 N MARTEL AVE
Mailing Address - Street 2:
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90046-6611
Mailing Address - Country:US
Mailing Address - Phone:323-436-5019
Mailing Address - Fax:323-337-9142
Practice Address - Street 1:7777 FOREST LN
Practice Address - Street 2:BUILDING B
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75230-2571
Practice Address - Country:US
Practice Address - Phone:323-436-5019
Practice Address - Fax:323-337-9142
Is Sole Proprietor?:No
Enumeration Date:2012-12-28
Last Update Date:2012-12-28
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant