Healthcare Provider Details

I. General information

NPI: 1467427898
Provider Name (Legal Business Name): CHRISTINE ANN CORTES CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2006
Last Update Date: 11/18/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR
SAN DIEGO CA
92103-9000
US

IV. Provider business mailing address

9150 SPICE ST
LA MESA CA
91941-5662
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-3163
  • Fax:
Mailing address:
  • Phone: 619-698-9159
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number1485
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: