Provider Demographics
NPI:1467597476
Name:ORTIZ, JULIO CESAR (INDEPENDENT DUTY HM)
Entity Type:Individual
Prefix:
First Name:JULIO
Middle Name:CESAR
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:INDEPENDENT DUTY HM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1869 CLEARWATER DR
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93012-4306
Mailing Address - Country:US
Mailing Address - Phone:310-570-5820
Mailing Address - Fax:
Practice Address - Street 1:NAVAL AMBULATORY CARE CTR
Practice Address - Street 2:162 FIRST ST.
Practice Address - City:PORT HUENEME
Practice Address - State:CA
Practice Address - Zip Code:93043-4316
Practice Address - Country:US
Practice Address - Phone:805-982-6310
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman