Provider Demographics
NPI:1316407026
Name:ORTIZ ILIZALITURRI, ANA KAREN (MD, MPH)
Entity Type:Individual
Prefix:
First Name:ANA
Middle Name:KAREN
Last Name:ORTIZ ILIZALITURRI
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 H STREET
Mailing Address - Street 2:CV112
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910
Mailing Address - Country:US
Mailing Address - Phone:619-691-7587
Mailing Address - Fax:619-240-3508
Practice Address - Street 1:435 H ST
Practice Address - Street 2:CV112
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910
Practice Address - Country:US
Practice Address - Phone:619-691-7587
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-20
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA390200000X
CAA178949207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPTL172OtherPOSTGRADUATE TRAINING LICENSE