Healthcare Provider Details

I. General information

NPI: 1669176459
Provider Name (Legal Business Name): JULIAN ENRIQUE ORTIZ DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 09/29/2025
Certification Date: 09/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2081 WOODS AVE
MONTEREY PARK CA
91754-5913
US

IV. Provider business mailing address

2081 WOODS AVE
MONTEREY PARK CA
91754-5913
US

V. Phone/Fax

Practice location:
  • Phone: 323-774-7896
  • Fax:
Mailing address:
  • Phone: 323-774-7896
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number34.018177
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number58.033499
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: