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General NPI Number Information
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NPI Number | 1497112999
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Entity Type | Organization
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Legal Business Name | JOSE E OTERO MD INC
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Dates
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Enumeration Date | 01/28/2016
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Last Update Date | 01/28/2016
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Provider Practice Location Address
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Address Line | 6367 ALVARADO CT STE 104
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City | SAN DIEGO
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State | CA
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Zip | 92120-4914
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Country | US
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Telephone | 619-229-1211
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Fax | 619-229-1141
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Provider Business Mailing Address
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Address Line | 6367 ALVARADO CT STE 104
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City | SAN DIEGO
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State | CA
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Zip | 92120-4914
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Country | US
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Telephone | 619-229-1211
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Fax | 619-229-1141
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOSE ENRIQUE OTERO
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Credential | M.D.
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Telephone | 619-229-1211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number | A30334
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License Number State | CA
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