Provider Demographics
NPI:1124213897
Name:OTANEZ, GEORGE ARTHUR (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:ARTHUR
Last Name:OTANEZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1393 BAILEY DR
Mailing Address - Street 2:
Mailing Address - City:HANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:93230-5922
Mailing Address - Country:US
Mailing Address - Phone:559-582-4481
Mailing Address - Fax:559-582-6547
Practice Address - Street 1:1393 BAILEY DR
Practice Address - Street 2:
Practice Address - City:HANFORD
Practice Address - State:CA
Practice Address - Zip Code:93230-5922
Practice Address - Country:US
Practice Address - Phone:559-582-4481
Practice Address - Fax:559-582-6547
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG526872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry