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General NPI Number Information
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NPI Number | 1689094518
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Entity Type | Individual
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Provider Name | ALBERT ORTEZA ANTONIO D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/17/2014
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Last Update Date | 10/15/2024
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Provider Practice Location Address
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Address Line | 24411 HEALTH CENTER DR
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City | LAGUNA HILLS
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State | CA
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Zip | 92653-3651
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Country | US
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Telephone | 949-452-7165
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Fax |
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Provider Business Mailing Address
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Address Line | 26901 76TH AVE DEPARTMENT OF NEONATAL PERINATAL MEDICINE
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City | NEW HYDE PARK
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State | NY
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Zip | 11040-1433
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Country | US
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Telephone |
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Fax |
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 20A15264
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License Number State | CA
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