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NPI Code Detail

MEDICARE: DR. RONALD JOSEPH ORTIZ M.D.

MEDICARE: DR. RONALD JOSEPH 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
1174400000XSpecialistA71725CA
2207Q00000XFamily Medicine PhysicianA71725CA

General Provider Information

NPI Number : 1235205774
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. RONALD JOSEPH ORTIZ M.D.
Provider Business Mailing Address
First Line : 17360 BROOKHURST ST
Second Line : ATTN: CREDENTIALING DEPARTMENT
City : FOUNTAIN VALLEY
State : CA
Zip : 92708-3720
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1212 W 17TH ST
Second Line :
City : SANTA ANA
State : CA
Zip : 92706-3418
Country : US
Telephone Number : 714-954-0432
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/27/2006
Last Update Date : 04/15/2016

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