MEDICARE: JULIO CORTES

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	2355S0801X	Speech-Language Assistant	SPA1738	CA

General Provider Information

NPI Number	:	1245804228
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JULIO CORTES

Provider Business Mailing Address
First Line	:	1917 W GARRY AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-6148
Country	:	US
Telephone Number	:	714-305-7393
Fax Number	:

Provider Business Practice Location Address
First Line	:	1917 W GARRY AVE
Second Line	:
City	:	SANTA ANA
State	:	CA
Zip	:	92704-6148
Country	:	US
Telephone Number	:	714-305-7393
Fax Number	:

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

Provider Enumeration Date	:	05/14/2021
Last Update Date	:	05/14/2021

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Directions to “ JULIO CORTES ” Practice Location

Language	Start Address	Practice Location

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