MEDICARE: DR. CRISANTO ORTIZ ORTIZ-LUIS PHARM 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	183500000X	Pharmacist	55392	CA

General Provider Information

NPI Number	:	1285615427
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CRISANTO ORTIZ ORTIZ-LUIS PHARM D

Provider Business Mailing Address
First Line	:	8341 JAYSEEL ST
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-2400
Country	:	US
Telephone Number	:	818-293-1949
Fax Number	:

Provider Business Practice Location Address
First Line	:	8341 JAYSEEL ST
Second Line	:
City	:	SUNLAND
State	:	CA
Zip	:	91040-2400
Country	:	US
Telephone Number	:	818-293-1949
Fax Number	:

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

Provider Enumeration Date	:	11/07/2005
Last Update Date	:	07/08/2007

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Directions to “ DR. CRISANTO ORTIZ ORTIZ-LUIS PHARM D” Practice Location

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