Provider Demographics
NPI:1245364397
Name:BORTZ, SHERI L (MD)
Entity type:Individual
Prefix:DR
First Name:SHERI
Middle Name:L
Last Name:BORTZ
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 1:2047 MONTECITO AVE
Mailing Address - Street 2:APT. (
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94043-4366
Mailing Address - Country:US
Mailing Address - Phone:650-969-8410
Mailing Address - Fax:
Practice Address - Street 1:12224 SARATOGA SUNNYVALE RD
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-3047
Practice Address - Country:US
Practice Address - Phone:408-446-4774
Practice Address - Fax:408-446-9422
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG38079208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice