Provider Demographics
NPI:1629230065
Name:CORTEZ, VLADIMIR ADRIANO (DO)
Entity Type:Individual
Prefix:DR
First Name:VLADIMIR
Middle Name:ADRIANO
Last Name:CORTEZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:434 EDGEMONT DR
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-7201
Mailing Address - Country:US
Mailing Address - Phone:909-809-2101
Mailing Address - Fax:
Practice Address - Street 1:508 CAJON ST STE B
Practice Address - Street 2:
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92373-5982
Practice Address - Country:US
Practice Address - Phone:909-283-4101
Practice Address - Fax:909-283-4105
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2023-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A104472084V0102X, 2085N0700X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No2084V0102XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyVascular NeurologyGroup - Single Specialty
No2085N0700XAllopathic & Osteopathic PhysiciansRadiologyNeuroradiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1629230065Medicaid
CA1629230065Medicaid