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General NPI Number Information
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NPI Number | 1124405956
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Entity Type | Individual
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Provider Name | RONALD ORTIZO
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Gender | Male
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Dates
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Enumeration Date | 04/30/2015
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 6405 DAY ST
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City | RIVERSIDE
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State | CA
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Zip | 92507-0901
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Country | US
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Telephone | 951-697-5464
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Fax | 951-697-5445
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Provider Business Mailing Address
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Address Line | 6405 DAY ST
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City | RIVERSIDE
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State | CA
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Zip | 92507-0901
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Country | US
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Telephone | 951-697-5464
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Fax | 951-697-5445
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | A147111
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License Number State | CA
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