Provider Demographics
NPI:1437701208
Name:CORTEZ, DAVID ANGEL (MSN- FNP)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:ANGEL
Last Name:CORTEZ
Suffix:
Gender:M
Credentials:MSN- FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 S GRAND AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90015-3999
Mailing Address - Country:US
Mailing Address - Phone:323-669-4346
Mailing Address - Fax:323-635-1891
Practice Address - Street 1:4618 FOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1830
Practice Address - Country:US
Practice Address - Phone:323-953-7170
Practice Address - Fax:323-663-2379
Is Sole Proprietor?:No
Enumeration Date:2019-07-11
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95011840363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily