Healthcare Provider Details

I. General information

NPI: 1659326007
Provider Name (Legal Business Name): JAYNE GALERA CORTEZ DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2006
Last Update Date: 12/03/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 N STATE COLLEGE BLVD SUITE 100
ANAHEIM CA
92806-2920
US

IV. Provider business mailing address

PO BOX 536
YORBA LINDA CA
92885-0536
US

V. Phone/Fax

Practice location:
  • Phone: 714-520-8470
  • Fax: 714-520-8471
Mailing address:
  • Phone: 714-520-8470
  • Fax: 714-520-8471

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE4524
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: