| Doctor Name: | MR. JOSE ANGEL ORTIZ |
| NPI Number: | 1073523072 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A.-C. |
| License Number: | PA 12395 |
| Business Practice Address: | 11919 Hesperia Rd Hesperia, CA - 923451855 |
| Business Phone Number: | 7609481454 |
| Business Fax Number: | 7609486100 |
| Mailing Address: | Po Box 4237, COVINA |
| State: | CA |
| Postal Code: | 917230637 |
| Phone Number: | 6267329593 |
| Fax Number: | |
| NPI Enumeration Date: | 08/09/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA 12395 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |