Healthcare Provider Details

I. General information

NPI: 1497679716
Provider Name (Legal Business Name): DANIEL JAMES ORTIZ PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2026
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 S CHAPARRAL CT STE 150
ANAHEIM CA
92808-2278
US

IV. Provider business mailing address

2962 MCALLISTER ST
RIVERSIDE CA
92503-6112
US

V. Phone/Fax

Practice location:
  • Phone: 714-998-9580
  • Fax:
Mailing address:
  • Phone: 909-695-9717
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number54849
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: