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NPI Code Detail

MEDICARE: MR. DON JUAN ORTIZ PA-C

MEDICARE:  MR. DON JUAN ORTIZ  PA-C
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
1363AM0700XMedical Physician Assistant17862CA

General Provider Information

NPI Number : 1831135409
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. DON JUAN ORTIZ PA-C
Provider Business Mailing Address
First Line : 12823 LUISENO ST
Second Line :
City : POWAY
State : CA
Zip : 92064-2008
Country : US
Telephone Number : 858-592-6540
Fax Number :
Provider Business Practice Location Address
First Line : 465 COLLEGE BLVD.
Second Line : STE. 1
City : OCEANSIDE
State : CA
Zip : 92057
Country : US
Telephone Number : 760-630-8400
Fax Number : 760-630-8594
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/21/2006
Last Update Date : 07/09/2007

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Directions to “ MR. DON JUAN ORTIZ PA-C” Practice Location

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