Healthcare Provider Details

I. General information

NPI: 1437315769
Provider Name (Legal Business Name): DANIEL ALEJANDRO CORTEZ M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2008
Last Update Date: 02/10/2020
Certification Date: 02/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 COYLE AVE DEPT OF PATHOLOGY
CARMICHAEL CA
95608-0306
US

IV. Provider business mailing address

PO BOX 340850
SACRAMENTO CA
95834-0850
US

V. Phone/Fax

Practice location:
  • Phone: 916-537-5275
  • Fax: 916-672-1524
Mailing address:
  • Phone: 916-634-7767
  • Fax: 916-672-1524

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZC0500X
TaxonomyCytopathology Physician
License NumberA107614
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA107614
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: