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NPI Code Detail

MEDICARE: PASCUAL JOSE ORTIZ B.S.

MEDICARE: PASCUAL JOSE ORTIZ B.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor
2171R00000XInterpreter

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1V8063705OTHERCADMV DL
21669559878OTHERCAMEDICAL

General Provider Information

NPI Number : 1780712075
Entity Type Code : Individual
Provider Name (Legal Business Name) : PASCUAL JOSE ORTIZ B.S.
Provider Business Mailing Address
First Line : 4705 N SONORA AVE STE 113
Second Line :
City : FRESNO
State : CA
Zip : 93722-3965
Country : US
Telephone Number : 559-276-7558
Fax Number :
Provider Business Practice Location Address
First Line : 4705 N SONORA AVE STE 113
Second Line :
City : FRESNO
State : CA
Zip : 93722-3965
Country : US
Telephone Number : 559-276-7558
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/01/2007
Last Update Date : 09/30/2011

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Directions to “ PASCUAL JOSE ORTIZ B.S.” Practice Location

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