Basic Information
| Provider Information | |||||||||
| NPI: | 1457569766 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PARAMORE | ||||||||
| FirstName: | ORA | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | CAS CERTIFICATION | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1773 CALLE PLATICO | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920566916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607320668 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2821 OCEANSIDE BLVD | ||||||||
| Address2: | |||||||||
| City: | OCEANSIDE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 920544800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7607212781 | ||||||||
| FaxNumber: | 7607219571 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/18/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 01-067661 | 01 | CA | CAS | OTHER |