Provider Demographics
NPI:1811237456
Name:ORTIZ, FRANKLIN ALEXANDER (DPT)
Entity Type:Individual
Prefix:
First Name:FRANKLIN
Middle Name:ALEXANDER
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10309 SANTA MONICA BLVD
Mailing Address - Street 2:STE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-5007
Mailing Address - Country:US
Mailing Address - Phone:310-553-5984
Mailing Address - Fax:
Practice Address - Street 1:23456 HAWTHORNE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4716
Practice Address - Country:US
Practice Address - Phone:310-540-7381
Practice Address - Fax:310-316-1788
Is Sole Proprietor?:No
Enumeration Date:2013-02-19
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA39785174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist