MEDICARE: CARLOS ORTIZ

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	237700000X	Hearing Instrument Specialist	9014	CA

General Provider Information

NPI Number	:	1922834860
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CARLOS ORTIZ

Provider Business Mailing Address
First Line	:	750 N COMMONS DR STE 200
Second Line	:
City	:	AURORA
State	:	IL
Zip	:	60504-7940
Country	:	US
Telephone Number	:	630-303-5380
Fax Number	:	630-303-5385

Provider Business Practice Location Address
First Line	:	100 N BRAND BLVD STE 203
Second Line	:
City	:	GLENDALE
State	:	CA
Zip	:	91203-2657
Country	:	US
Telephone Number	:	818-476-0084
Fax Number	:	818-539-2251

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

Provider Enumeration Date	:	09/09/2024
Last Update Date	:	09/09/2024

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Directions to “ CARLOS ORTIZ ” Practice Location

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