Provider Demographics
NPI:1003157496
Name:CORTEZ, EMILIO ALEJANDRO I
Entity Type:Individual
Prefix:MR
First Name:EMILIO
Middle Name:ALEJANDRO
Last Name:CORTEZ
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5740 RALSTON ST STE 200
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003-6009
Mailing Address - Country:US
Mailing Address - Phone:805-289-3203
Mailing Address - Fax:
Practice Address - Street 1:5740 RALSTON ST STE 200
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-6009
Practice Address - Country:US
Practice Address - Phone:805-289-3203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-08
Last Update Date:2013-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator