Provider Demographics
NPI:1639343817
Name:CORDTS, JOHN T
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:T
Last Name:CORDTS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3711 LONG BEACH BLVD
Mailing Address - Street 2:STE. 600
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90807-3315
Mailing Address - Country:US
Mailing Address - Phone:562-216-1707
Mailing Address - Fax:562-981-7569
Practice Address - Street 1:3711 LONG BEACH BLVD
Practice Address - Street 2:STE. 600
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90807-3315
Practice Address - Country:US
Practice Address - Phone:562-216-1707
Practice Address - Fax:562-981-7569
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist