Provider Demographics
NPI:1659556165
Name:ORTIZ, ARISA ELENA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARISA
Middle Name:ELENA
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 1:4829 BELLA PACIFIC ROW
Mailing Address - Street 2:#215
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92109-2380
Mailing Address - Country:US
Mailing Address - Phone:818-744-3322
Mailing Address - Fax:
Practice Address - Street 1:8899 UNIVERSITY CENTER LN
Practice Address - Street 2:SUITE 350
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92122-1013
Practice Address - Country:US
Practice Address - Phone:949-824-7103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-02
Last Update Date:2013-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA101163207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology