Provider Demographics
NPI:1952304859
Name:ORTIZ, XAVIER GUILLERMO (MD)
Entity Type:Individual
Prefix:DR
First Name:XAVIER
Middle Name:GUILLERMO
Last Name:ORTIZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:534 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:NAPA
Mailing Address - State:CA
Mailing Address - Zip Code:94559-1537
Mailing Address - Country:US
Mailing Address - Phone:513-470-9394
Mailing Address - Fax:
Practice Address - Street 1:975 SERENO DR
Practice Address - Street 2:
Practice Address - City:VALLEJO
Practice Address - State:CA
Practice Address - Zip Code:94589-2441
Practice Address - Country:US
Practice Address - Phone:707-914-6399
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG148485207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000188840OtherANTHEM
OH0720549OtherUNITED HEALTCARE
OH311575051045OtherCARSOURCE
OH2504772OtherAETNA
OH160051478OtherMEDICARE RAILROAD
OH2038093Medicaid
OH64339OtherHUMANA
OH288092OtherAMERIGROUP
OH64339OtherHUMANA
OH288092OtherAMERIGROUP
OH160051478OtherMEDICARE RAILROAD
OHOR0787505Medicare PIN