Healthcare Provider Details

I. General information

NPI: 1295775443
Provider Name (Legal Business Name): MATILDA CORTEZ GARCIA M.D., MPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1705 W MAIN ST ADELANTE HEALTHCARE
MESA AZ
85202
US

IV. Provider business mailing address

1705 W MAIN ST ADELANTE HEALTHCARE
MESA AZ
85201-6920
US

V. Phone/Fax

Practice location:
  • Phone: 877-809-5092
  • Fax: 480-840-1834
Mailing address:
  • Phone: 877-809-5092
  • Fax: 480-840-1834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number21673
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: