Provider Demographics
NPI:1407072192
Name:ORTIZ, ELIZABETH C (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:C
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 31309
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90031-0309
Mailing Address - Country:US
Mailing Address - Phone:323-226-7873
Mailing Address - Fax:323-226-4224
Practice Address - Street 1:325 N SAINT PAUL ST STE 3100
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75201-3923
Practice Address - Country:US
Practice Address - Phone:214-253-9395
Practice Address - Fax:866-458-6930
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95637207RR0500X
TXS5240207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1366185118OtherGROUP NPI
1215670070OtherGROUP NPI
CA1902846306OtherGROUP NPI