Provider Demographics
NPI:1114535176
Name:CORTES, MARICHU QUIZON (RN)
Entity Type:Individual
Prefix:
First Name:MARICHU
Middle Name:QUIZON
Last Name:CORTES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29160 HEATHERCLIFF RD # 4051
Mailing Address - Street 2:
Mailing Address - City:MALIBU
Mailing Address - State:CA
Mailing Address - Zip Code:90265-6315
Mailing Address - Country:US
Mailing Address - Phone:310-663-4443
Mailing Address - Fax:
Practice Address - Street 1:22809 PACIFIC COAST HWY
Practice Address - Street 2:
Practice Address - City:MALIBU
Practice Address - State:CA
Practice Address - Zip Code:90265-5040
Practice Address - Country:US
Practice Address - Phone:310-663-4443
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-16
Last Update Date:2020-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95067526163WM0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0102XNursing Service ProvidersRegistered NurseMaternal Newborn