Organization Name: | EVELYN A ORTEGA MD INC |
NPI Number: | 1477799682 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | EVELYN A ORTEGA (PRESIDENT) |
Mailing Address: | 910 S Sunset Ave Suite 5 West Covina |
State: | CA US |
Postal Code: | 917903409 |
Phone Number: | 6269602771 |
Fax Number: | 6269608112 |
NPI Enumeration Date: | 12/18/2008 |
NPI Last Update Date: | 02/19/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |