Provider Demographics
NPI:1376708602
Name:ORTEGO, JOSEPH NEIL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:NEIL
Last Name:ORTEGO
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:307 W. FOURTH ST
Mailing Address - Street 2:REGION II POC
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90013
Mailing Address - Country:US
Mailing Address - Phone:310-412-6134
Mailing Address - Fax:310-412-6355
Practice Address - Street 1:101 N. LA BREA AVE, STE 201
Practice Address - Street 2:INGLEWOOD PAROLE CLINICS 4 & 6
Practice Address - City:INGLEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90301-1769
Practice Address - Country:US
Practice Address - Phone:310-412-6134
Practice Address - Fax:310-412-6355
Is Sole Proprietor?:No
Enumeration Date:2008-07-25
Last Update Date:2008-07-25
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Provider Licenses
StateLicense IDTaxonomies
CA452412084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA$$$$$$$$$Medicare UPIN