MEDICARE: DR. JOSE A ORTIZ M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A73634	CA

General Provider Information

NPI Number	:	1134218555
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSE A ORTIZ M.D.

Provider Business Mailing Address
First Line	:	3900 W 3RD ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-2675
Country	:	US
Telephone Number	:	213-427-0400
Fax Number	:	213-427-0411

Provider Business Practice Location Address
First Line	:	3900 W 3RD ST
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90020-2675
Country	:	US
Telephone Number	:	213-427-0400
Fax Number	:	213-427-0411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/12/2006
Last Update Date	:	12/11/2020

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Directions to “ DR. JOSE A ORTIZ M.D.” Practice Location

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